scholarly journals Predictors of suicidal behavior in patients with cognitive impairments in depressive disorders

2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 58-64
Author(s):  
N. Maruta ◽  
S. Yaroslavtsev

The aim of the study was to determine predictors of suicide risk in patients with cognitive impairment in depressive disorders.Material and methods. 362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder, 141 patients with bipolar affective disorder and 98 patients with prolonged depressive reaction. A set of research methods was used to study the factors of suicidal behavior in patients with cognitive impairment in depressive disorders: clinical-psychopathological, psychodiagnostic (questionnaire "Self-assessment of the severity of autoaggressive predictors") and mathematical-statistical. Results of the research. Predictors of suicide risk in patients with cognitive impairment in depressive disorders were identified. The moderate level of autoaggression and aggression, low level of impulsivity, high and severe narrowing of cognitive functions, severe narrowing of interpersonal relationships, severity of affective disorders, moderate and severe autonomic disorders were identified in patients with recurrent depressive disorder. Pronounced and moderate level of autoaggression, aggression and impulsivity, high and pronounced level of narrowing of cognitive functions, pronounced narrowing of interpersonal relationships, severity of affective disorders, moderate and severe level of autonomic disorders were identified in patients with bipolar affective disorder. Moderate levels of autoaggression and narrowing of cognitive functions, low levels of aggression, severe impulsivity, affective disorders and narrowing of interpersonal relationships, and high levels of autonomic disorders were identified in patients with prolonged depressive reaction.Conclusions. As a result of the study, the features of suicidal behavior in patients with cognitive impairment in depressive disorders were identified. It can act as diagnostic criteria and predictors of suicidal behavior in differential diagnostics and could take into account when creating psychocorrectional programs aimed at reducing suicidal risk in patients with cognitive dysfunctions in depressive disorders.

Author(s):  
Serhii Yaroslavtsev

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinical-psychopathological and statistical. As a result of the study, the clinical and psychopathological features of affective disorders in different types of depressive disorders were identified: a predominance of apathy, emotional lability, hypothymia, anxiety, feelings of dissatisfaction, despair and anhedonia were identified in patients with RDD; a low mood, apathy, emotional coldness, hypothymia, ambivalence of emotions, dysphoria, dissatisfaction, feelings of sadness and annoyance were identified in patients with BAD; a feelings of despair, anxiety, dissatisfaction, hypothymia, fear, sadness, feelings of horror and fear, emotional lability, feelings of anger, hostility and shame and sensitivity were dominated in patients with PDR.


Author(s):  
S. A. Yaroslavtsev

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). It was found that cognitive dysfunctions were less pronounced in patients with PDR, than in patients with RDD and BAR (p<0,035). Cognitive dysfunctions in depressive disorders was underlined by the presence of disorders in the mental sphere, in the sphere of attention, executive, visual-spatial and linguistic functions. The differential features of cognitive impairment in patients with RDD, BAR and PDR are highlighted and it should be taken during conducting differential diagnosis of cognitive impairment in depressive disorders. Keywords: patients with cognitive impairment, depressive disorders, cognitive dysfunctions, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction.


Author(s):  
Serhii Yaroslavtsev

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinical-psychopathological, psychodiagnostic (Munsterberg test) and statistical. The features of the perception process were established for various types of depressive disorders: in patients with RDD, there was a predominance of average, increased and decreased selectivity of attention to neutral stimulus (30.89 %, 21.95 % and 21.95 %, respectively), high selectivity of attention to negative stimulus (33.33 %) and decreased and low selectivity of attention to positive stimulus (54.47 % and 20.33 %, respectively); in patients with BAD, a predominance of average and reduced selectivity of attention to neutral stimulus (45.39 % and 36.17 %, respectively) and average selectivity of attention to negative and positive stimulus (38.30 % and 38.30 %, respectively) were recorded; in patients with PDR, the prevalence of average and reduced selectivity of attention to neutral stimulus (42.86 % and 34.69 %, respectively), increased and decreased selectivity of attention to negative stimulus (29.59 % and 16.33 %, respectively), increased selectivity of attention to positive stimulus (43.88 %). Key words: patients with cognitive impairment, depressive disorders, perception process, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction


Author(s):  
Serhii Yaroslavtsev

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder, 141 patients with bipolar affective disorder and 98 people with prolonged depressive reaction. Peculiarities of the process of attention of patients with depressive disorders were the presence of a decrease in concentration, stability and switching of attention, decrease in work efficiency and working capacity. The peculiarities of the functioning of attention indicators were determined for various types of depressive disorders, which can use as diagnostic criteria in the differential diagnosis of cognitive impairment in depressive disorders. Key words: cognitive impairment, depressive disorders, persistence, concentration and switching of attention, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction


Author(s):  
Catarina Magalhães Porto ◽  
Natalia Santos Barbosa da Silva ◽  
Cecília Magalhães Porto Lira ◽  
Rayana Porpino Magalhães ◽  
José Luiz Oliveira Magalhães ◽  
...  

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.


Author(s):  
Marcela Pereira ◽  
Roberto Andreatini ◽  
Per Svenningsson

The diagnosis of major depressive disorder (MDD) relies on the presence of a certain number of signs and symptoms, including feelings of guilt, hopelessness, dysphoria, cognitive dysfunction, persistent sleep, and appetite abnormalities. These signs and symptoms overlap with other conditions such as anxiety, bipolar, and seasonal affective disorders. This chapter provides an overview of the basic neurobiological mechanisms underlying MDD and its treatment. There are several alterations in the molecular pathways and neuronal networks associated with MDD. The chapter focuses here on: gene × environment interactions, dysfunctional brain circuitries, neurotransmitter alterations, maladaptation in neurotrophins and neuroplasticity, hypothalamus–pituitary–adrenal (HPA) axis dysfunction, abnormal immune system responses, circadian arrhythmicity, and sleep disturbances. The chapter briefly describes the mechanisms of actions for approved antidepressant therapies and also discusses recent insights into the pathophysiology of MDD and future possible therapy targets.


Author(s):  
Kelly C. Cukrowicz ◽  
Erin K. Poindexter

Suicide is a significant concern for clinicians working with clients experiencing major depressive disorder (MDD). Previous research has indicated that MDD is the diagnosis more frequently associated with suicide, with approximately two-thirds of those who die by suicide suffering from depression at the time of death by suicide. This chapter reviews data regarding the prevalence of suicidal behavior among those with depressive disorders. It then reviews risk factors for suicide ideation, self-injury, and death by suicide. Finally, the chapter provides an empirical overview of treatment studies aimed at decreasing risk for suicide, as well as an overview of several recent treatment approaches showing promise in the reduction of suicidal behavior.


2008 ◽  
Vol 39 (5) ◽  
pp. 763-771 ◽  
Author(s):  
J. G. Fiedorowicz ◽  
A. C. Leon ◽  
M. B. Keller ◽  
D. A. Solomon ◽  
J. P. Rice ◽  
...  

BackgroundSuicide is a leading cause of death and has been strongly associated with affective disorders. The influence of affective disorder polarity on subsequent suicide attempts or completions and any differential effect of suicide risk factors by polarity were assessed in a prospective cohort.MethodParticipants with major affective disorders in the National Institute of Mental Health (NIMH) Collaborative Depression Study (CDS) were followed prospectively for up to 25 years. A total of 909 participants meeting prospective diagnostic criteria for major depressive and bipolar disorders were followed through 4204 mood cycles. Suicidal behavior was defined as suicide attempts or completions. Mixed-effects, grouped-time survival analysis assessed risk of suicidal behavior and differential effects of risk factors for suicidal behavior by polarity. In addition to polarity, the main effects of age, gender, hopelessness, married status, prior suicide attempts and active substance abuse were modeled, with mood cycle as the unit of analysis.ResultsAfter controlling for age of onset, there were no differences in prior suicide attempts by polarity although bipolar participants had more prior severe attempts. During follow-up, 40 cycles ended in suicide and 384 cycles contained at least one suicide attempt. Age, hopelessness and active substance abuse but not polarity predicted suicidal behavior. The effects of risk factors did not differ by polarity.ConclusionsBipolarity does not independently influence risk of suicidal behavior or alter the influence of well-established suicide risk factors within affective disorders. Suicide risk assessment strategies may continue to appraise these common risk factors without regard to mood polarity.


2017 ◽  
Vol 41 (S1) ◽  
pp. s239-s239
Author(s):  
H. Kozhyna ◽  
V. Mykhaylov ◽  
K. Zelenskay

The work covers the study of the formation of suicidal behavior in young adults with depressive disorders and developing of pathogenetic based system of its prevention. There were clinical and psychopathological signs of depressive disorders in young patients analyzed. Anxiety, asthenia, asthenic-apathetic and melancholy variants of depressive disorders in young patients with suicidal behavior were highlighted. In this study, there were the markers of suicide risk for young patients with depressive disorders determined: high suicide risk, low death self-consciousness, high anhedonia level, clinical manifestations of anxiety and depression by the hospital anxiety and depression scale, severe anxiety and depression by the Hamilton anxiety rating scale, major depressive episode by the Montgomery-Asberg depression rating scale. It has been proved that in observed young patients with depressive disorders with suicide behavior increased concentrations of serotonin, cortisol, noradrenaline and decreased levels of adrenaline and melatonine in plasma were observed. These changes were determined as neurohormonal background for depletion of adaptation resource in stress situations. There were approaches to differentiated prevention of suicidal behavior in depressive disorders in young people validated that include pharmacotherapy (selective SSRI, melatonin, serotonin and norepinephrine), psychotherapy and psychoeducation. Psychotherapeutic complexin patients with depressive episode must include personality-oriented psychotherapy, cognitive behavioral therapy, family therapy and autogenous training; in disorders of adaptation – rational psychotherapy, cognitive-behavioral analytic psychotherapy, family therapy, autogenic training. Psychoeducation should be carried out using information modules, training a positive self-image, improved compliance; formation of communication skills, problem solving, interpersonal interaction and problem-oriented discussions.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2019 ◽  
Vol 84 (3) ◽  
pp. 61-69
Author(s):  
R.I. Isakov

252 women with depressive disorders were examined: 94 people were with psychogenic (prolonged depressive reaction caused by adjustment disorder), 83 women were with endogenous (depressive episode; recurrent depressive disorder; bipolar disorder, current episode of depression) and 75 patients were with organic depression (organic affective disorders). 48 women had no signs of psychosocial maladaptation, the remaining 204 had manifestations of macrosocial, mesosocial and microsocial maladaptation of varying severity. The features of family anxiety in women with depression of various origins and different severity of macrosocial, mesosocial and microsocial maladaptation were investigated in order to determine the target targets of differentiated psychosocial rehabilitation of patients in this contingent. Clinical-psychopathological and psychodiagnostic methods were used. There was revealed a general tendency towards an increase in the indicators of family guilt, family anxiety and family tension as the degree of macrosocial, mesosocial and microsocial maladaptation increased. At the same time, the greatest differences in indicators were observed between the groups with moderate and severe maladaptation, and the smallest differences were observed between the groups without signs of disadaptation and with signs of mild maladaptation. The data obtained should be taken into account when developing treatment and rehabilitation measures for patients of this contingent.


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