Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior

Oquendo, María A.; Friend, Jeff M.; Halberstam, Batsheva; Brodsky, Beth S.; Burke, Ainsley K.; Grunebaum, Michael F.; Malone, Kevin; Mann, J. John

doi:10.1176/appi.ajp.160.3.580

Cited by 190 publications

(125 citation statements)

References 13 publications

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“…Suicidal behavior is associated with a deficient 5-HT system (Mann et al, 1998), and altered 5-HT functioning was found in the ventromedial and lateral prefrontal cortex, which might be associated with the predisposition to suicidal behavior due to the impaired restraint mechanisms (Oquendo et al, 2003;Lauterbach et al, 2006). Our findings of the lower platelet 5-HT concentration in suicidal PTSD and comparative psychiatric patients suggest that platelet 5-HT concentration is related to particular trait markers (Askenazy et al, 2000;Peirson et al, 1999), and that platelet 5-HT may distinguish between PTSD subjects with and without suicidal behavior.…”

Section: Principal Findingsmentioning

confidence: 99%

Platelet serotonin concentration and suicidal behavior in combat related posttraumatic stress disorder

Kovačić

Henigsberg

Pivac

et al. 2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Section: Principal Findingsmentioning

confidence: 99%

Platelet serotonin concentration and suicidal behavior in combat related posttraumatic stress disorder

Kovačić

Henigsberg

Pivac

et al. 2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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“…Presence and severity of mental illnesses like depression and PTSD were assessed routinely, a finding consistent with the literature regarding distal risk factors [6,7,[9][10][11]. Discussion of acute stressors, social support, and present use of alcohol and drugs also suggested that phase 3 encounters examined more proximal suicide risk factors [7,8,[14][15][16].…”

Section: Discussionmentioning

confidence: 55%

“…Distal suicide risk factors such as mental and medical illnesses represent relatively stable backdrops against which SI or suicidal behavior occurs [5]. For example, existing research indicates that suicide risk is elevated among persons with mental illness generally [6] and particularly among those with mood disorders [7], substance abuse/dependence problems [8], anxiety and posttraumatic stress disorder [9][10][11], self-reported physical illness [7,12], and chronic pain [13]. Psychosocial issues can be conceptualized as more proximal suicide risk factors, which exist on their own or in concert with distal risks.…”

mentioning

confidence: 99%

Suicide risk management: development and analysis of a telephone-based approach to patient safety

Campbell

Bonner

Bolkan

et al. 2011

Behav. Med. Pract. Policy Res.

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Research-based queries about patients' experiences often uncover suicidal thoughts. Human subjects review requires suicide risk management (SRM) protocols to protect patients, yet minimal information exists to guide researchers' protocol development and implementation efforts. The purpose of this study was to examine the development and implementation of an SRM protocol employed during telephone-based screening and data collection interviews of depressed primary care patients. We describe an SRM protocol development process and employ qualitative analysis of de-identified documentation to characterize protocol-driven interactions between research clinicians and patients. Protocol development required advance planning, training, and team building. Three percent of screened patients evidenced suicidal ideation; 12% of these met protocol standards for study clinician assessment/intervention. Risk reduction activities required teamwork and extensive collaboration. Research-based SRM protocols can facilitate patient safety by (1) identifying and verifying local clinical site approaches and resources and (2) integrating these features into prevention protocols and training for research teams. Suicidal ideation (SI) and behavior are significant for healthcare management across clinical and research settings. Within research studies, ethical practice mandates suicide risk management (SRM) protocols to guide researchers' efforts to maximize patient safety [1,2]. Key stakeholders in the adequacy of these protocols include patients who participate in research, the researchers who study patients at risk for suicide, and the Institutional Review Boards (IRB) that oversee research activities. Several important management tasks are relevant for research-based SRM. Detection tasks include identifying those research participants who evidence high risk and require SRM protocol entry [2]. Essential management tasks include the development and implementation of specific plans and identification and training of specific personnel to perform risk management activities [1,2].Guidance regarding the detection of suicidal threat can be found in the suicide literature, which characterizes risk across numerous domains [3]. Socio-demographic risks for suicide include age, gender, and ethnicity, with white men and older adults accounting for disproportionately high rates of completed suicides [4]. Distal suicide risk factors such as mental and medical illnesses represent relatively stable backdrops against which SI or suicidal behavior occurs [5]. For example, existing research indicates that suicide risk is elevated among persons with mental illness generally [6] and particularly among those with mood disorders [7], substance abuse/dependence problems [8], anxiety and posttraumatic stress disorder [9-11], self-reported physical illness [7,12], and chronic pain [13]. Psychosocial issues can be conceptualized as more proximal suicide risk factors, which exist on their own or in concert with distal risks. More proximal or transient fac...

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“…Presenting psychiatric diseases following a sexual assault is seen on women more than men according to many studies [20,[23][24][25][26]. One study showed that there is no difference between two sexes in terms of developing PTSD after sexual assault [27].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with PTSD in Cases of Sexual Assault

Çelikel¹,

Özsoy²,

Zeren³

2015

J Psychiatry

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Aim: Acute stress disorder, depression and post-traumatic stress disorder (PTSD) can be seen in people who have been sexually assaulted. The aim of this study is to evaluate the socio-demographic characteristics of cases that are exposed to sexual assault and their relationship with PTSD. Materials and Methods:The forensic reports of 175 sexual assault cases were analyzed retrospectively who were assessed in terms of physical and mental health disorders by Hatay Forensic Medicine Directorate between January 2011-March 2013.Results: Of all victims, 143 (81,7%) were female and 32 (18,3%) were male. The ages of cases were ranged between 1 and 71 (median: male: 12, female: 16). It was determined that PTSD was developed in 47 victims after sexual assault and 3 cases were referred to a higher center. Sexual assaults were occurred more often in the home environment and victims were assaulted by people they knew (n: 123, 70,3%). PTSD development was significantly higher in victims who were assaulted by anal and vaginal route (p<0,001). There was no significant difference in the presence of PTSD between male and female victims. However it is observed that presence of PTSD increases with age (p<0,05). Conclusion:As a conclusion it is found that sexual assault by anal and vaginal region and older ages are the significant risk factors for development of PTSD.

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Association of Comorbid Posttraumatic Stress Disorder and Major Depression With Greater Risk for Suicidal Behavior

Abstract: The greater rate of suicide attempts among patients with comorbid PTSD and major depressive episode was not due to differences in substance use, childhood abuse, or cluster B personality disorders.

Cited by 190 publications

References 13 publications

Platelet serotonin concentration and suicidal behavior in combat related posttraumatic stress disorder

Platelet serotonin concentration and suicidal behavior in combat related posttraumatic stress disorder

Suicide risk management: development and analysis of a telephone-based approach to patient safety

Factors Associated with PTSD in Cases of Sexual Assault

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