Atopic dermatitis (AD) is associated with psychologic distress. However, previous studies found conflicting results about whether AD is associated with increased depression or suicidality.
To ...determine the complex relationship between AD and depression.
A systematic review of all published observational studies in the MEDLINE, PubMed, Embase, Global Resource for Eczema Trials (GREAT), Latin American and Caribbean Health Sciences (LILACS), the Cochrane Library, Scopus, and PsychInfo databases that analyzed depression in AD was performed. Two reviewers performed study title and/or abstract review and data abstraction. Pooled meta-analysis was performed by using random-effects weighting.
Overall, 106 studies met the inclusion criteria; 36 had sufficient data for meta-analysis. The prevalence of any depression was higher in persons with versus without AD (20.1% vs 14.8%). Similar results were found in sensitivity analyses of studies assessing clinical depression, depressive symptoms, and adults; studies with healthy controls; and studies of low and high study quality. AD was associated with significantly higher depression scale scores, parental depression, antidepressant use, and suicidality. No publication bias was detected.
Individual-level data were not available.
Patients with AD have higher odds of depression and suicidality.
Abstract
Introduction
This prospective study explored associations among clinical insomnia, nocturnal cognitive hyperarousal, and nocturnal perinatal-focused rumination with suicidal ideation (SI) in ...perinatal women with mild-to-moderate depression.
Methods
From late pregnancy through early postpartum, 39 women with depression completed 17 weekly surveys assessing insomnia, depression, suicidal ideation, perceived stress, and three cognitive arousal indices.
Results
Women with nocturnal cognitive hyperarousal at baseline, relative to those with low nocturnal cognitive arousal, were at greater risk for developing new onset SI in late pregnancy or early postpartum (33% vs 1%). Moreover, nocturnal perinatal-focused rumination was independently associated with SI. SI-risk was highest when women reported clinical insomnia combined with nocturnal cognitive hyperarousal (OR=5.66, p=.037) or perinatal-focused rumination (OR=11.63, p=.018). Daytime perseverative thinking was not uniquely associated with SI.
Conclusion
Cognitive hyperarousal and perinatal-focused rumination at night are uniquely associated with SI among perinatal women with depression. Moreover, insomnia augments the suicidogenicity of nighttime cognitive activity. Future research should determine whether alleviating nocturnal cognitive arousal, pregnancy- and fetal/infant-related concerns, and insomnia with psychotherapy reduces SI for women with perinatal depression.
Support (if any)
This study was funded by the American Academy of Sleep Medicine (198-FP-18, PI: Kalmbach). Dr. Cheng’s effort was supported by the National Heart, Lung, and Blood Institute (K23-HL13866, PI: Cheng).
Half of patients with schizophrenia experience suicidal ideation. Only few studies have examined the effects of recent stress on both current and emergent suicidal ideation.A cohort of 85 patients ...with schizophrenia spectrum disorders was assessed. The study was divided into a cross-sectional and longitudinal arms to test the effect of recent stress on suicidal ideation. Analysis was done using logistic regression models.After correcting for covariates, recent stress had no significant effect on current suicidal ideation. However, increased total stress (odds ratio OR = 1.099 1.032–1.170, p = 0.003) and health-related stress (OR = 1.331 1.074–1.650, p = 0.009) at follow-up were predictive of emergent suicidal ideation.With this sample size, we were unable to draw firm conclusions regarding the effect of specific life events on suicidal ideation. Further studies involving larger samples that investigate the interplay between several risk factors are needed.
Suicide is a leading cause of death worldwide and perhaps the most puzzling and devastating of all human behaviors. Suicide research has primarily been guided by verbal theories containing vague ...constructs and poorly specified relationships. We propose two fundamental changes required to move toward a mechanistic understanding of suicide. First, we must formalize theories of suicide, expressing them as mathematical or computational models. Second, we must conduct rigorous descriptive research, prioritizing direct observation and precise measurement of suicidal thoughts and behaviors and of the factors posited to cause them. Together, theory formalization and rigorous descriptive research will facilitate abductive theory construction and strong theory testing, thereby improving the understanding and prevention of suicide and related behaviors.
Due to scientific advances, there have been significant declines in many once-leading causes of death over the past 100 years, yet global suicide rates have remained fairly stable for decades. The lack of progress in understanding, predicting, and preventing suicide is due in part to the limitations of current scientific theories of suicide.After providing a brief history of suicide theories, we argue that these theories are limited due to two fundamental factors: (i) they are imprecise, comprising vaguely defined components and underspecified relationships among those components, precluding concrete theory predictions that could be tested; and (ii) there is a lack of rigorous descriptive research that is necessary to inform the generation, testing, and development of more precise theories.We provide several guiding principles to address these limitations, focusing on the need to formalize theories as mathematical and computational models and to collect rigorous and intensive descriptive research on key suicidal outcomes and the factors posited to give rise to those outcomes.
This study examined the different dimensions and instruments used in committing suicide and how it gave rise to suicidal thoughts among Nigerian university students who had witnessed these suicide ...cases posted in social media platforms. Convenience sample of 30 students who had witnessed social media reported suicides were studied using focus group discussion. It was found that suicide a single person affair becomes a group affair through the power of its postings in social media platforms which generates different discussions on it. Students tend to have different suicidal thoughts following suicides they watched in social media platforms. These suicidal thoughts come in the form of high suicidal ideation, near suicidal ideation and no suicidal ideation. Use of sniper (a chemical used in killing insects) in committing suicide by students generated more thoughts of suicide especially when posted in social media platforms than other means of committing suicide.
War profoundly impacts people’s lives, causing death, displacement, and psychological trauma, but research investigating suicidality of adolescents in this context has been limited. We compared ...suicidality or self-harm behavior among adolescents in regions that were, and were not, affected by Russia’s initial invasion of Ukraine in 2014.
This cross-sectional study comprised 2,752 school students aged 11 to 17 years from the war-affected Donetsk region and non-war Kirovograd region. Data collection occurred in 2016 and 2017 using self-report tools to assess suicidality or self-harm behavior; psychopathology including posttraumatic stress disorder (PTSD), depression, and anxiety; and war trauma exposure.
Adolescent girls in the war-affected region reported more suicide attempts (9.5% vs 5.1%; adjusted odds ratio aOR 1.8, 95% CI 1.2-2.8), suicidal ideation (39.3% vs 19.6%; aOR 2.6, 95% CI 2.01-3.3), or self-harm behavior (19.6% vs 13.1%; aOR 1.6, 95% CI 1.2-2.1), and boys reported more suicidal ideation (17.0% vs 9.8%; aOR 1.7, 95% CI 1.2-2.4). Boys and girls with PTSD, depression, or anxiety showed increased risks for any suicidality or self-harm. A dose-effect relation was observed between war trauma exposure and suicidality or self-harm. The association was strongest for adolescents who had experienced 5 or more different war trauma exposures (aOR 3.2, 95% CI 2.2-4.8).
War trauma exposure and psychopathology were strongly associated with suicidality or self-harm behavior, with a greater impact in girls than boys. The high prevalence of suicidality found in this study emphasizes the need for intervention on a large scale for adolescents living in war situations.
The efficacy of ketamine in reducing suicidal ideation (SI) has been previously reported. We aimed to evaluate acute anti-SI effects of single-dose ketamine in different formulations/routes of ...administration by pooling results from randomized controlled trials (RCTs). A systematic search was conducted on Cochrane, Embase, Medline, and PubMed from inception to July 1st, 2020. Studies were selected based on pre-determined eligibility criteria. Effect sizes of different formulations/routes at various time points were computed using random-effects models. With data from nine eligible RCTs (n = 197), the pooled effect size for anti-SI effects at the 24-h time point was 1.035 (N = 6, CI: 0.793 to 1.277, p < 0.001) for intravenous (IV) racemic ketamine and 1.309 (N = 1, CI: 0.857 to 1.761, p < 0.001) for intranasal (IN) esketamine. An additional five RCTs were available for qualitative analysis. RCTs were identified for oral/sublingual ketamine for depression, however, none of these trials reported anti-SI effects preventing quantitative analysis for these routes of delivery. No RCTs for intramuscular (IM) ketamine were identified. The findings suggest that single-dose IV ketamine/IN esketamine is associated with robust reductions in suicidal thoughts at 2-h, 4-h, and 24-h post-intervention. In addition, future studies on IM/oral/sublingual ketamine and comparative studies are warranted to evaluate the anti-SI efficacy of distinct formulations and routes of administration.
•Single-dose intravenous ketamine/intranasal esketamine has rapid and robust acute effects in reducing suicidal ideation (SI).•Future high-quality research on the anti-SI efficacy of alternative administration routes and formulations of ketamine is needed.•Dosage, routes of administration, and formulations are factors to be considered for optimizing SI treatment using ketamine.
Objective:
Ketamine may reduce suicidal ideation in treatment-resistant depression. But it is not known how quickly this occurs and how long it persists. We undertook a systematic review and ...meta-analysis to determine the short- and long-term effectiveness of ketamine for suicidality.
Method:
CENTRAL, EMBASE, Medline, and PsycINFO were searched until 12 December 2018. Randomised controlled trials of ketamine or esketamine reporting data on suicidal ideation, self-harm, attempted or completed suicide in adults diagnosed with any psychiatric disorder were included. Two reviewers independently extracted data, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. Standardised mean difference was used for continuous outcomes.
Results:
Twenty-five reports from 15 independent trials, with a total of 572 participants diagnosed with predominately affective disorders, were included. The evidence was rated moderate to low. In most trials, ketamine was administered at 0.5 mg/kg via a single intravenous infusion over a 30- to 45-minute period. Only a single trial of intranasal esketamine was identified. At 4 hours post-infusion, treatment with ketamine was associated with a significant reduction in suicidal ideation scores (standardised mean difference = −0.51, 95% confidence interval = −1.00, −0.03), which persisted until 72 hours post-infusion (time points between 12 and 24 hours: standardised mean difference = −0.63, 95% confidence interval = −0.99, −0.26; between 24 and 72 hours: standardised mean difference = −0.57, 95% confidence interval = −0.99, −0.14), but not thereafter. However, there was marked heterogeneity of results. In a single trial of esketamine, marginal effects on suicidal ideation were observed. In terms of actual suicidal behaviour, there were virtually no data on effects of ketamine or esketamine.
Conclusion:
A single infusion of ketamine may have a short-term (up to 72 hours) beneficial impact on suicidal thoughts. While confirmation of these results in further trials is needed, they suggest possible use of ketamine to treat acute suicidality. Means of sustaining any anti-suicidal effect need to be found.
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