Background: Severe suicide ideation or attempts and non-suicidal self-injury (NSSI) present both differences and relevant overlaps, including frequent co-occurrence and shared risk factors. Specific categorical diagnoses, namely bipolar disorder (BD), may affect clinical features and natural histories of suicidal or not suicidal self-harm behaviour. Our study aimed to compare suicidality (severe suicidal ideation or suicidal attempts) and NSSI in referred bipolar adolescents. Methods: The sample included 95 bipolar adolescents (32 males, 63 females) aged 11 to 18 years. Thirty adolescents with suicide attempts/suicidal ideation and BD (SASIB) were compared with structured measures to 35 adolescents with NSSI and BD, without suicidal ideation or attempts (NSSIB), and to 30 adolescents with BD, without suicidal ideation or attempts or NSSI (CB). Results: Compared to CB, suicidality and NSSI were both associated with female sex, borderline personality disorder and self-reported internalizing disorders, anxiety/depression and thought disorders. The NSSI were specifically associated with somatic problems. Severe suicidal ideation and suicide attempts were associated with adverse life events, immigration, bullying, eating disorders, social problems, depressive feelings, performance and social anxiety, and feelings of rejection. Conclusions: Both shared and differential features between suicidal and not suicidal adolescents may represent possible targets for diagnostic and preventative interventions.
Symptoms are often difficult to quantify, represent and depict for the patients and sometime also for the attending physicians. Anyway their role is crucial in influencing the relationship patient/physician in many ways. Respiratory symptoms (cough, thoracic pain, dispnoea) are not free of this challenging drawback. In asthmatic patients the subjective awareness of their disease condition, expecially their insight in the quality of breathing pattern, is critical to assess severity and control of their disease: under-perception of respiratory symptoms make this task problematic for patients and physicians. To estimate the magnitude of problem two set of reports have been examined: one on "real life" patients with chronic stable asthma and secondly studies evaluating the level of perception in selected asthmatic patients in a laboratory setting using bronchial provocation tests tool. Cumulatively a rough percentage of 20% asthmatic patients showed a reduced ability to be aware of their low level of pulmonary function. This impaired ability to perceive and report symptoms could also be a harbinger of undesirable and sometimes dangerous consequences. These data show that poor perception in asthma is a challenging problem affecting a large proportion of patients, with the potential of severe outcomes that need to be accurately addressed.
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