Substance abuse, temperament and suicide risk: evidence from a case-control study.
ABSTRACT The aim of the current study was to evaluate differences between two matched groups of psychiatric outpatients (those with and those without substance abuse) on clinical variables that previous research has suggested may be associated with substance abuse comorbidity. The sample consisted of 31 consecutively admitted psychiatric outpatients (16 men and 15 women) with substance use comorbidity; controls were 31 outpatients without substance use comorbidity who were matched for sex and age. The patients completed the Mini International Neuropsychiatric Interview, the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version, the Symptom Checklist-90-Revised, the Gotland Male Depression Scale, and the Beck Hopelessness Scale. As a group, the substance abusers had a different temperament profile (higher dysthymic/cyclothymic/anxiety and irritability and lower hyperthymic traits), a higher hopelessness, global psychopathology severity, impulsivity/aggression, and suicide risk (higher lifetime suicide ideation and suicide attempts), and were more frequently depressed. However, few differences were significant and almost all were of small magnitude. Furthermore, bipolar disorders type II were overrepresented in the abuser group compared to the control group (45% vs. 22%, respectively).
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ABSTRACT: Objective To review scores on measures of impulsivity in remitted bipolar disorder. Data source We used keywords “impulsivity and bipolar”; “impulsivity and mania” to narrow down our search on Medline, EMBASE and Psychinfo to include those studies that had reported impulsivity scores using validated and reliable assessment measures in remitted bipolar disorder (Both I & II). We searched all English language studies from 1990 to October 2012. Study Selection 19 reports met the inclusion criteria and were reviewed by two abstractors independently. Data abstraction We generated weighted mean differences (WMDs) from pooled data using RevManager 5.0 from Cochrane analysis. Results The Barratt Impulsivity Scale (BIS) 11 was the instrument most commonly used. 19 studies met inclusion criteria, of which 2 were excluded due to incomplete data. A WMD of 12.8 was observed for BIS 11 total scores, 4.3 on the motor component, 4.1 on the cognitive and 7.6 on the non-planning components of the BIS 11 respectively. Conclusion Impulsivity is significantly higher in remitted bipolar patients than normal controls. Non-planning impulsivity is a key domain affected in bipolar disorder, which may represent a stable trait.Comprehensive Psychiatry 10/2014; · 2.26 Impact Factor
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ABSTRACT: Background: Mood disorders (MD) are disabling conditions throughout the world associated with significant psychosocial impairment. Affective temperaments, as well as hopelessness, may play a significant role in the pathophysiology of MD. The present study was designed to characterize patients with MD for their prevalent affective temperament and level of hopelessness. Methods: Five hundred fifty-nine (253 men and 306 women) consecutive adult inpatients were assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A), the Gotland Scale for Male Depression (GSMD), the Beck Hopelessness Scale (BHS) and the Mini International Neuropsychiatric Interview (MINI). Results: Higher cyclothymia and irritable temperaments were found in bipolar disorder-I (BD-I) patients compared to those with other Axis I diagnoses. Major depressive disorder (MDD) patients had lower hyperthymia than BD-I and BD-II patients and higher anxiety than patients with other Axis I diagnoses. Severe "male" depression was more common in BD-II patients compared to BD-I and MDD patients. BD-I patients and those with other axis I diagnoses reported lower BHS Z 9 scores than those with BD-II and MDD. Limitations: The study had the limitations of all naturalistic designs, that is, potentially relevant variables were not addressed. Furthermore, the cross-sectional nature of the study did not allow conclusions about causation, and the use of self-report measures could be potentially biased by social desirability. Conclusion: MDD patients were more likely to have higher anxious temperament, higher hopelessness and lower hyperthymic temperament scores, while BD-I patients more often had cyclothymic and irritable temperaments than patients with other Axis I diagnoses. The implications of the present results were discussed.Journal of Affective Disorders 06/2014; 166:285-291. · 3.71 Impact Factor
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ABSTRACT: Suicide attempters who met criteria for borderline personality disorder (BPD) comorbid with major depressive disorder (MDD) were compared to both suicide attempters suffering from MDD alone and to attempters with comorbid MDD and other personality disorders (PD). Participants were 239 (158 patients with comorbid PD and 81 patients with MDD without comorbidity) inpatients consecutively admitted after a suicide attempt made in the last 24 hours. Suicide attempters with comorbid MDD and BPD had more frequent previous suicide attempts and were more likely to have a history of aggressive behaviors and alcohol and drug use disorders compared with patients suffering from MDD without Axis II comorbidity.Suicide and Life-Threatening Behavior 10/2013; · 1.40 Impact Factor