Article

Sex differences in clinical predictors of suicidal acts after major depression: A prospective study

Department of Neuroscience, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., New York, NY 10032, USA.
American Journal of Psychiatry (Impact Factor: 13.56). 02/2007; 164(1):134-41. DOI: 10.1176/appi.ajp.164.1.134
Source: PubMed

ABSTRACT Whether sex differences exist in clinical risk factors associated with suicidal behavior is unknown. The authors postulated that among men with a major depressive episode, aggression, hostility, and history of substance misuse increase risk for future suicidal behavior, while depressive symptoms, childhood history of abuse, fewer reasons for living, and borderline personality disorder do so in depressed women.
Patients with DSM-III-R major depression or bipolar disorder seeking treatment for a major depressive episode (N=314) were followed for 2 years. Putative predictors were tested with Cox proportional hazards regression analysis.
During follow-up, 16.6% of the patients attempted or committed suicide. Family history of suicidal acts, past drug use, cigarette smoking, borderline personality disorder, and early parental separation each more than tripled the risk of future suicidal acts in men. For women, the risk for future suicidal acts was sixfold greater for prior suicide attempters; each past attempt increased future risk threefold. Suicidal ideation, lethality of past attempts, hostility, subjective depressive symptoms, fewer reasons for living, comorbid borderline personality disorder, and cigarette smoking also increased the risk of future suicidal acts for women.
These findings suggest that the importance of risk factors for suicidal acts differs in depressed men and women. This knowledge may improve suicide risk evaluation and guide future research on suicide assessment and prevention.

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    • "Another mediating factor seems to be the degree of religiosity and religious affiliation, which modify the risk for SBs (Gearing & Lizardi, 2009). The examination of a large international sample may clarify the cross-cultural influence of religious affiliation, gender and other cultural factors (Oquendo et al., 2007). -Aggression traits and their relation to suicide (Turecki, 2005). "
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    ABSTRACT: Current methodologies employed in collecting data for suicide research present several limitations. In this article, we describe a novel method and tool to prospectively study suicidal behavior and its related risk and protective factors in different countries. This tool is a web-based database, which will initially be developed and piloted by suicide research groups from Brazil, Chile, Dubai, France, Italy, Mexico, Spain, Sweden and the US. The database will develop and integrate research tools key to collaboration, permit exploration of ethical considerations, and provide a universal interface in English, Spanish, French, Portuguese, Italian and German that will make it possible to incorporate new groups from different countries to the network. The common database resulting of this cross-national effort will allow researchers to share and compare data across countries in a large sample of patients. Using electronic records of patients, we will: 1) determine the impact of risk and protective factors (viz. aggression and religious affiliation) in different socio-cultural environments; 2) develop a clinical model of suicidal behavior that integrates the multiple dimensions implicated; 3) try differentiating the effects of biological, environmental and cultural factors on suicidal behavior, and 4) offer the global psychiatric research community a tool that will standardize assessment across nations allowing for better generalization.
    Archives of Suicide Research 12/2014; DOI:10.1080/13811118.2014.981624 · 1.64 Impact Factor
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    • "Another mediating factor seems to be the degree of religiosity and religious affiliation, which modify the risk for SBs (Gearing & Lizardi, 2009). The examination of a large international sample may clarify the cross-cultural influence of religious affiliation, gender and other cultural factors (Oquendo et al., 2007). -Aggression traits and their relation to suicide (Turecki, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Current methodologies employed in collecting data for suicide research present several limitations. In this article, we describe a novel method and tool to prospectively study suicidal behavior and its related risk and protective factors in different countries. This tool is a web-based database, which will initially be developed and piloted by suicide research groups from Brazil, Chile, Dubai, France, Italy, Mexico, Spain, Sweden and the US. The database will develop and integrate research tools key to collaboration, permit exploration of ethical considerations, and provide a universal interface in English, Spanish, French, Portuguese, Italian and German that will make it possible to incorporate new groups from different countries to the network. The common database resulting of this cross-national effort will allow researchers to share and compare data across countries in a large sample of patients. Using electronic records of patients, we will: 1) determine the impact of risk and protective factors (viz. aggression and religious affiliation) in different socio-cultural environments; 2) develop a clinical model of suicidal behavior that integrates the multiple dimensions implicated; 3) try differentiating the effects of biological, environmental and cultural factors on suicidal behavior, and 4) offer the global psychiatric research community a tool that will standardize assessment across nations allowing for better generalization.
    Archives of Suicide Research 12/2014; · 1.64 Impact Factor
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    • "The posterior probabilities of each group for each AAO in SA were computed given Bayes formula, which allowed us to determine the most probable subgroup for each patient. Subsequently, suicide attempters were categorized according to their maximum probability of belonging to each theoretical subgroup [19]. Percentages were computed to derive sociodemographic, psychiatric diagnoses, risk factors, and SA and treatment correlates of AAO. "
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    ABSTRACT: To define different subgroups of suicide attempters according to age at onset of suicide attempts. Participants were 229 suicide attempters (147 females; 82 males) admitted to a general hospital in Madrid, Spain. We used admixture analysis to determine the best-fitting model for the age at onset of suicide attempts separated by sex. The best fitted model for the age at onset of suicide attempts was a mixture of two gaussian distributions. Females showed an earlier age at onset of suicide attempts in both Gaussian distributions (mean ± S.D.) (26.98 ± 5.69 and 47.98 ± 14.13) than males (32.77 ± 8.11 and 61.31 ± 14.61). Early-onset female attempters were more likely to show borderline personality disorder than late-onset female attempters (OR = 11.11; 95% CI = 2.43-50.0). Age at onset of suicide attempts characterizes different subpopulations of suicide attempters.
    The Scientific World Journal 05/2012; 2012:825189. DOI:10.1100/2012/825189 · 1.73 Impact Factor
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