| 41. |
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| 42. |
- Lindqvist, Daniel, et al.
(författare)
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CSF biomarkers in suicide attempters - a principal component analysis.
- 2011
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 124, s. 52-61
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Tidskriftsartikel (refereegranskat)abstract
- Lindqvist D, Janelidze S, Erhardt S, Träskman-Bendz L, Engström G, Brundin L. CSF biomarkers in suicide attempters - a principal component analysis. Objective: The objective of the present study was to identify biological patterns (factors) among 20 cerebrospinal fluid (CSF) biomarkers in suicide attempters and subsequently analyse their association with suicidal behaviour. Method: We measured kynurenic acid, orexin, homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), 3-methoxy-4-hydroxyphenylglycol, chemokines, matrix metalloproteases and cytokines in the CSF of 124 drug-free suicide attempters. Patients were evaluated for suicidality and psychiatric symptoms using well-defined psychiatric rating scales and followed-up regarding future suicide. We used principal component analysis to identify factors among the biological substances. Results: Four factors were extracted from the 20 biomarkers, explaining 52.4% of the total variance. Factors 1 and 2 were characterized by high loadings of chemokines and cytokines respectively. They were both associated with severe depressive symptoms. Factor 2 was also associated with a high suicidal intent. Factor 4 was characterized by strong loadings of the monoamine metabolites 5-HIAA and HVA, as well as orexin and interleukin-6. High scores on this factor were found in patients who performed a violent suicide attempt and in patients who subsequently completed suicide. Conclusion: Our results suggest that specific combinations of CSF biomarkers may discriminate between types of suicidal behaviour and indicate increased risk for future suicide.
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| 43. |
- Lindqvist, Daniel, et al.
(författare)
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Increased Plasma Levels of Circulating Cell-Free Mitochondrial DNS in Suicide Attempters - Associations with HPA-Axis Hyperactivity
- 2017
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Ingår i: Biological Psychiatry. - : Elsevier. - 0006-3223 .- 1873-2402. ; 81:10, s. S228-S228
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Preclinical data suggest that chronic stress may cause cellular damage and mitochondrial dysfunction, potentially leading to the release of mitochondrial DNA (mtDNA) into the bloodstream. Major Depressive Disorder has been associated with an increased amount of mtDNA in leukocytes from saliva samples and blood, but no previous studies have measured plasma levels of free-circulating mtDNA in a clinical psychiatric sample.Methods: In this study, free circulating mtDNA was quantified in plasma samples from 37 suicide attempters, who had undergone a dexamethasone suppression test (DST), and 37 healthy controls. We hypothesized that free circulating mtDNA would be elevated in the suicide attempters and associated with hypothalamic pituitary adrenal (HPA)-axis hyperactivity. Results: Suicide attempters had significantly higher plasma levels of free-circulating mtDNA compared to healthy controls at different time points (pre- and post-DST) (all p-values ,2.98E-12, Cohen’s d ranging from 2.55-4.01). Pre-DST plasma levels of mtDNA were positively correlated with postDST cortisol levels (rho50.49, p,0.003).Conclusions: Suicide attempters may have elevated plasma levels of free-circulating mtDNA, which are related to impaired HPA-axis negative feedback. This peripheral index is consistent with increased cellular or mitochondrial damage. The specific cells and tissues contributing to plasma levels of free-circulating mtDNA are not known, as is the specificity of this finding for suicide attempters. Future studies are needed in order to better understand the relevance of increased freecirculating mtDNA in relation to the pathophysiology underlying suicidal behavior and depression.
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| 44. |
- Lindqvist, Daniel, et al.
(författare)
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Interleukin-6 Is Elevated in the Cerebrospinal Fluid of Suicide Attempters and Related to Symptom Severity
- 2009
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Ingår i: BIOLOGICAL PSYCHIATRY. - : Elsevier BV. - 0006-3223 .- 1873-2402. ; 66:3, s. 287-292
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depressive disorders are associated with immune system alterations that can be detected in the blood. Cytokine concentrations in cerebrospinal fluid (CSF) and their relationship to aspects of suicidality have previously not been investigated. Methods: We measured interleukin-1 beta interleukin-6 (IL-6), interleukin-8, and tumor necrosis factor-a (TNF-alpha) in CSF and plasma of suicide attempters (n = 63) and healthy control subjects (n = 47). Patients were classified according to diagnosis and violent or nonviolent suicide attempt. We evaluated suicidal ideation and depressive symptoms using the Suicide Assessment Scale and the Montgomery-Asberg Depression Rating Scale (MADRS). We also analyzed the relation between cytokines and monoamine metabolites 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in CSF, as well as the integrity of the blood-brain barrier as reflected by the CSF:serum albumin ratio. Results: IL-6 in CSF was significantly higher in suicide attempters than in healthy control subjects. Patients who performed violent suicide attempts displayed the highest IL-6. Furthermore, there was a significant positive correlation between MANS scores and CSF IL-6 levels in all patients. IL-6 and TNF-a correlated significantly with 5-HIAA and HVA in CSF, but not with MHPG. Cytokine levels in plasma and CSF were not associated, and patients with increased blood-brain barrier permeability did not exhibit elevated cytokine levels. Conclusions: We propose a role for CSF IL-6 in the symptomatology of suicidal behavior, possibly through mechanisms involving alterations of dopamine and serotonin metabolism.
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| 45. |
- Lindqvist, Daniel, et al.
(författare)
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Salivary cortisol and suicidal behavior-A follow-up study.
- 2008
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 33:8, s. 1061-1068
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Hyperactivity of the hypothalamic-pituitary-adrenal (HPA)-axis is a common finding in major depressive disorder. Similar studies on suicide attempters are less abundant, and the results are divergent. The main aim of the present study was to investigate HPA-axis parameters by the time of a suicide attempt and at follow-up in search for associations between HPA-axis function and suicidal behavior. METHODS: Thirty-five suicide attempters and 16 non-suicidal controls were admitted to a psychiatric ward between the years of 1986 and 1992. Corticotrophin-releasing hormone (CRH) in cerebrospinal fluid and urinary cortisol were obtained for the suicide attempters. The patients were followed up approximately 12 years after the index admission. Cortisol was measured in saliva, and additional suicide attempts and current psychiatric symptoms were registered. RESULTS: At follow-up, evening salivary cortisol was lower in suicide attempters compared to controls. Low cortisol levels at follow-up were associated with severe psychiatric symptoms. Among women, repeated suicide attempts were associated with low morning and lunch salivary cortisol, and in this subgroup we also found significant correlations between salivary cortisol at follow-up, and CRH as well as urinary cortisol at index. CONCLUSION: We found evidence for an association between low HPA-axis activity and suicidal behavior. This could be due to long-lasting and severe psychiatric morbidity, which in turn has exhausted the HPA-axis of these patients. The potential role of hypocortisolism should be given more attention in studies on suicidal patients.
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| 46. |
- Lindqvist, Daniel, et al.
(författare)
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Suicidal intent and psychiatric symptoms among inpatient suicide attempters.
- 2007
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 61:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate associations between suicidal intent and psychiatric symptoms, and to study the usefulness of the Suicidal Intent Scale (SIS) and the Comprehensive Psychopathological Rating Scale (CPRS) for suicide risk assessment in an inpatient population. One hundred and ninety-six suicide attempters, of whom 15 eventually committed suicide, were admitted to a psychiatric ward. They were assessed by means of the SIS and the CPRS. Cox regression analyses were performed in order to adjust the relationships between the individual CPRS subscales and suicide for age and gender. The patients who later completed suicide had higher scores on the CPRS than the patients who did not complete suicide. We found no associations between symptoms and suicidal intent. The severity of psychopathology, in terms of high CPRS scores, shows a stronger association with future suicide than the level of suicidal intent (SIS) among inpatient suicide attempters. Suicidal intent is evidently scored regardless of psychiatric symptoms.
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| 47. |
- Lindqvist, Daniel, et al.
(författare)
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Suicidal Intent and the HPA-Axis Characteristics of Suicide Attempters with Major Depressive Disorder and Adjustment Disorders.
- 2008
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Ingår i: Archives of Suicide Research. - : Informa UK Limited. - 1543-6136 .- 1381-1118. ; 12:3, s. 197-207
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Tidskriftsartikel (refereegranskat)abstract
- The main purpose of the study was to investigate Hypothalamic-Pituitary-Adrenal (HPA) axis characteristics in relation to suicidal intent among suicide attempters with Major Depressive Disorder (MDD) and Adjustment Disorders (AD). The relationship between suicidal intent, assessed by means of the Suicidal Intent Scale (SIS), and serum cortisol after a Dexamethasone Suppression Test (DST) was investigated in 78 suicide attempters, divided into diagnostic subgroups. There was a significant negative correlation between suicidal intent and post DST cortisol in patients with MDD. Our findings may be attributed to pathophysiological processes, where a high suicidal intent is revealed during a potential chronic course of MDD, which in turnresults in a seemingly normal stress system.
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| 48. |
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| 49. |
- Lundvik Gyllensten, Amanda, et al.
(författare)
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Psychomotor functioning in suicide attempters. An explorative study using the Resource Oriented Body Examination of Bunkan
- 1997
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 51:3, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- Within physical therapy there is a tradition of focusing on body-oriented resources and psychomotor functioning. The aim of the present explorative study was to describe psychomotor functioning such as patterns of muscular tension, posture, resistance to passive movements, respiration, and reactions to palpation in a group of suicide attempters admitted to the Lund Suicide Research Center, Sweden. Fe-three consecutive patients were included in the study (28 women and 25 men; mean age, 42 years; standard deviation, 13; range, 21-80 years). The Resource Oriented Body Examination (ROBE) of Buncan was used to assess psychomotor functioning. In addition, some other tests were undertaken, such as laboratory tests (monoamine metabolites in cerebrospinal fluid and plasma cortisol after dexamethasone) and temperament ratings. Results indicated that the patients generally showed a high level of psychomotor disturbance as compared with reference values. The ROBE total score was significantly higher in patients who later completed suicide than in the non-completer group (P = 0.02). Two ROBE subgroups were identified. The hypotonic group (n = 19) showed a higher frequency of respiration disturbances (P = 0.01) than the hypertonic group (n = 34). The hypotonic subgroup also had a significantly higher rate of completed suicides at a follow-up 5 years later (P = 0.048). With regard to biochemical tests, the hypotonic group comprised significantly more cases with high levels of cortisol after dexamethasone (P = 0.02). In conclusion, controlled studies of psychomotor functioning in suicide attempters ought to be performed. In our opinion the results of the present study enerate interesting hypotheses.
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| 50. |
- Magne-Ingvar, Ulla, et al.
(författare)
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Suicide attempters with and without reported overconsumption of alcohol and tranquillizers
- 1997
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 51:6, s. 415-421
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to investigate the existence of overconsumption of alcohol and tranquillizers in suicide attempters and whether overconsumers differ from those with no overconsumption. One hundred and twenty-six patients, evaluated and treated after a suicide attempt in a psychiatric ward, took part in a comprehensive investigation. This included questions on consumption of alcohol and tranquillizers and use of illegal drugs, independently of the psychiatric diagnostic procedure. More than half of the patients (59%) reported overconsumption of any kind or use of illegal drugs; 47% overconsumed alcohol (13% in a combination with tranquillizers), 10% overconsumed tranquillizers only, and 2% had used illegal drugs. Compared with non-overconsumers, overconsumers had more often made previous suicide attempts, and psychiatric co-morbidity on DSM III-R was commoner among overconsumers. The parents of overconsumers had more often been treated for psychiatric disorders, and alcoholism among fathers was commoner. The overconsumers of alcohol were younger and less often married, had a weaker social network, and had lower platelet monoamine oxidase activity. The psychosocial characteristics found in overconsumers underline the need for identification of these subjects, to prevent an escalation of a self-destructive life-style. A thorough investigation concerning use of alcohol and other substances is therefore essential in all suicide attempters; otherwise there is a risk that overconsumers without a DSM III-R diagnosis of substance use disorder may be undetected.
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