Perform a meta-analysis to quantify the association between psychological pain and current or lifetime history of suicidal ideation or suicide attempt.
Search MEDLINE, Web of Science, and PsycINFO ...from 1965 to 2015 for (psychache OR mental pain OR psychological pain) AND (suicid*).
Observational case-control studies addressing the difference in psychological pain between individuals with and without current or lifetime history of suicidal ideation or suicide attempt.
Data were independently extracted into a standard electronic form. All authors were contacted for unpublished data related to current or lifetime history of suicide ideation or attempt.
Twenty studies were included. Comparisons concerned 760 subjects with versus 8,803 subjects without lifetime history of suicide attempt; 344 subjects with versus 357 patients without current suicide attempt; 262 patients with versus 64 patients without lifetime history of suicidal ideation; and 551 subjects with versus 7,383 subjects without current suicidal ideation. The intensity of psychological pain was higher (1) in both subjects with lifetime history of suicide attempts and subjects with current suicide attempts versus without (effect sizes = 0.72, P < 10⁻² and 0.66, P < 10⁻², respectively) and (2) in both subjects with lifetime history of suicide ideation and subjects with current suicidal ideation versus without (effect sizes = 1.49, P = .01 and 1.15, P < 10⁻², respectively). Association between psychological pain and suicidality remained significant even when depression levels were not different between subjects.
Higher psychological pain levels are associated with suicidal ideation and acts. Considering psychological pain to be at the core of suicidality is important for daily clinical practice and for the promotion of innovative therapeutic strategies for suicide prevention.
Lifetime major depression and grey-matter volume Ancelin, Marie-Laure; Isabelle, Carrière; Sylvaine, Artero ...
Journal of psychiatry & neuroscience,
2019, Volume:
43, Issue:
6
Journal Article
Peer reviewed
Open access
There is evidence of structural brain alterations in major depressive disorder (MDD), but little is known about how these alterations might be affected by age at onset or genetic vulnerability. This ...study examines whether lifetime episodes of MDD are associated with specific alterations in grey-matter volume, and whether those alterations vary according to sex or serotonin transporter-linked promoter region (5-HTTLPR) genotype (LL, SL or SS).
We used structural MRI to acquire anatomic scans from 610 community-dwelling participants. We derived quantitative regional estimates of grey-matter volume in 16 subregions using FreeSurfer software. We diagnosed MDD according to DSM-IV criteria. We adjusted analyses for age, sex, total brain volume, education level, head injury and comorbidities.
Lifetime MDD was associated with a smaller insula, thalamus, ventral diencephalon, pallidum and nucleus accumbens and with a larger pericalcarine region in both men and women. These associations remained after adjustment for false discovery rate. Lifetime MDD was also associated with a smaller caudate nucleus and amygdala in men and with a larger rostral anterior cingulate cortex in women. Late-onset first episodes of MDD (after age 50 years) were associated with a larger rostral anterior cingulate cortex and lingual and pericalcarine regions; early-onset MDD was associated with a smaller ventral diencephalon and nucleus accumbens. Some associations differed according to 5-HTTLPR genotype: the thalamus was smaller in participants with MDD and the LL genotype; pericalcarine and lingual volumes were higher in those with the SL genotype.
Major depressive disorder was associated with persistent volume reductions in the deep nuclei and insula and with enlargements in visual cortex subregions; alterations varied according to age of onset and genotype.
Conflicting results have been reported regarding the association between white matter lesions (WML) and cognitive impairment. We hypothesized that education, a marker of cognitive reserve (CR), could ...modulate the effects of WML on the risk of mild cognitive impairment (MCI) or dementia.
We followed 500 healthy subjects from a cohort of community-dwelling persons aged 65 years and over (ESPRIT Project). At baseline, WML volume was measured using a semi-automatic method on T2-weighted MRI. Standardized cognitive and neurological evaluations were repeated after 2, 4, and 7 years. The sample was dichotomized according to education level into low (≤8 years) and high (>8 years) education groups. Cox proportional hazard models were constructed to study the association between WML and risk of MCI/dementia.
The interaction between education level and WML volume reached significance (p = 0.017). After adjustment for potential confounders, the association between severe WML and increased MCI/dementia risk was significant in the low education group (≤8 years) (p = 0.02, hazard ratio HR: 3.77 1.29-10.99), but not in the high education group (>8 years) (p = 0.82, HR: 1.07 0.61-1.87).
Severe WML significantly increases the risk of developing MCI/dementia over a 7-year period in low educated participants. Subjects with higher education levels were seen to be more likely to be resilient to the deleterious effects of severe WML. The CR hypothesis suggests several avenues for dementia prevention.
Recent evidence suggests that a high glycemic load (GL) diet is a risk factor for dementia, especially among apolipoprotein E ε4 allele (
) carriers, while its association with cognitive decline is ...poorly known. Here, we investigated the association of high-GL meals with cognitive decline in older adults during a 12-year follow-up, according to their
carrier status. We used random-effect models and data from 2539 elderly participants from the Three-City study who completed a food frequency questionnaire (FFQ) to longitudinally assess the association of GL with changes in different cognitive domains (verbal fluency, visual memory, attention, visual motor processing speed, episodic memory). In
carriers, afternoon snack with high GL was significantly associated with cognitive decline in visual memory, episodic memory, and global cognition compared with
non-carriers. This study suggests a detrimental association between a high-GL diet and cognitive decline. The promotion of a low GL diet as a target to prevent cognitive decline in high-risk populations deserves more research.
Abstract Background Some MRI studies have noted alterations in the corpus callosum (CC) white matter integrity of individuals with mood disorders and also in patients with suicidal behavior. We ...investigated the specific impact of suicidal behavior on CC integrity in mood disorders. Methods CC structural changes were assessed by diffusion tensor imaging (DTI) in 121 women (18 to 50-year-old): 41 with bipolar disorder (BD), 50 with major depressive disorder (MDD) and 30 healthy controls (HC). Fractional anisotropy (FA) and DTI metrics were calculated for the genu, body and splenium of CC and compared in the three groups by MANCOVA. Then, they were re-analyzed relative to the suicide attempt history within the MDD and BD groups and to the suicide number/severity. Results FA values for the CC genu and body were lower in non-suicide attempters with BD than with MDD and in HC. Conversely, FA values for all CC regions were significantly lower in suicide attempters with BD than in HC. Finally, higher number of suicide attempts (>2) and elevated Suicidal Intent Scale score were associated with significant splenium alterations. Limitations Limitations include the cross-sectional design (non-causal study), the potential influence of medications and concerns about the generalizability to men. Conclusion Genu and body are altered in non-suicide attempters with BD, while splenium is specifically altered in suicide attempters, independently from their psychiatric status. History of suicide attempts may be a source of heterogeneity in the association between CC alterations and BD and may partially explain the variable results of previous studies.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Objective: To investigate: i) the association between level of social activity and late-life depressive symptoms and ii) the association between level of social activity and improvement in depressive ...symptoms over a 2-year period among people scoring above case level. Design: A secondary analysis of data from a prospective community-based study. Setting: Montpellier district, France. Participants: Community residents aged 65 and older (N = 1,849), 85.4% of whom were reassessed after a 2-year interval. Measurements: Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale at baseline and follow-up, and the standard 16 + cutoff was applied to define case-level symptomatology. The primary independent variable assessed at baseline was three levels of social activity defined from a 33-point scale. Other covariates included age, gender, marital status, education, alcohol consumption, chronic illness, cognitive impairment, disability, life events, and antidepressant use at baseline and follow-up. Results: In the sample at baseline (N = 1,849), higher social activity was negatively associated with case-level depressive symptomatology after adjustment for potential confounders (odds ratio across three groups 0.7, 95% confidence interval 0.6–0.8). In a prospective analysis of participants above case level at baseline (N = 463), high-social activity at baseline was the only variable associated with improvement in depressive symptoms and remained significant after adjustment for all other factors (odds ratio=1.6; 95% confidence interval = 1.2–2.2). Conclusions: In a large community sample, higher social activity was associated with a lower risk of late-life depressive symptoms at baseline and, in those with case-level baseline symptoms, was the principal factor predicting improvement over 2-year follow-up.
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NUK, ODKLJ, OILJ, UL, UM, UPUK
Background: Mild cognitive impairment (MCI) refers to the transitional zone between normal ageing and dementia. Current criteria perform poorly within the general population setting. Revisions have ...been proposed based on results obtained from clinical and epidemiological studies. Objective: To evaluate revised diagnostic criteria for mild cognitive impairment (MCI-R) incorporating changes in activity level and non-mnesic cognitive functioning. Method: MCI-R subjects were recruited from a representative network of general practitioners in the south of France. A computerized neuropsychometric examination was given. At 2 years of follow-up, a diagnosis of dementia was made by a neurologist using DSM-IIIR criteria and without knowledge of the results of the cognitive testing. Rates of conversion to incident dementia were assessed by receiver operating characteristics analysis. Results: The MCI-R prevalence was found to be 16.6% using revised criteria. A significantly better prediction of transition to dementia (AUC = 0.80, sensitivity: 95%, specificity: 66%) was obtained with MCI-R than with the previous MCI criteria (AUC = 0.48, sensitivity: 5%, specificity: 91%). The predictive power was found to increase when MCI subtypes were combined. Conclusion: Incorporating the possibility of change in activity level and alteration of non-mnesic cognitive functions have been found to ameliorate the original algorithm and better define subjects converting to dementia. This definition may be applicable to both clinical and population research.
Previous studies have highlighted links between a high-glycemic-load (GL) diet and Alzheimer’s disease in apolipoprotein E ε4 (APOE4) carriers. However, the impact of high-GL diet on plasma amyloid-β ...(Aβ), an Alzheimer’s disease hallmark that can be detected decades before clinical symptomatology, is unknown. This study examined the association between plasma Aβ peptides (Aβ40, Aβ42 concentration and Aβ42/Aβ40 ratio) and GL. The influence of the GL of four meal types (breakfast, lunch, afternoon snack, and dinner) was also determined. From the prospective Three-City study, 377 participants with plasma Aβ measurements, and who completed the Food Frequency Questionnaire, were selected. The association between plasma Aβ and GL was tested using an adjusted linear regression model. Lunch GL was associated with a lower plasma Aβ42 concentration (β = −2.2 CI = −4.27, −0.12, p = 0.038) and lower Aβ42/Aβ40 ratio (β = −0.009 CI = −0.0172, −0.0007, p = 0.034) in the model adjusted for center, age, sex, education level, APOE4 status, energy intake, serum creatinine, total cholesterol, and Mediterranean-like diet. No significant association was found with the GL of the other meal types. These results suggest that dietary GL may independently modulate the plasma Aβ of the APOE4 status. The mechanism underlying diet, metabolic response, and Aβ peptide regulation must be elucidated.
Aim: To investigate the association between subjective memory impairment (SMI) and objective cognitive impairment in later life, and to ascertain whether this is modified by level of social ...activity, education or living alone.
Methods: Data were analyzed from three French community surveys carried out in Bordeaux, Dijon and Montpellier. Representative samples of 9294 residents aged 65 years and over were included in the study. SMI was ascertained and investigated in relation to performance on the Benton Visual Retention Test (BVRT), the Isaac Set Test (IST) and Trail Making Test B (TMT). Adjustments were made for age, sex, education, depressive symptoms (Centre for Epidemiological Depression scale), site where study was carried out and living alone. Stratified analyses investigated modification by high or low social activity, education or living arrangement.
Results: SMI was reported by 21.9% of the sample, and was significantly associated with lower scores on BVRT and TMT after adjustment for age, sex, education, depressive symptoms, site and living alone. These associations were not significantly modified by social activity, education or living alone.
Conclusion: Worse subjective memory was associated independently with worse performance on two tests of cognitive function; however, in these cohorts, no evidence was found for modification of associations by social activity/support or education. Geriatr Gerontol Int 2013; 13: 139–145.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
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