Bipolar disorder. III: Harm avoidance a risk factor for suicide attempts

Engström, Christer; Brändström, Sven; Sigvardsson, Sören; Cloninger, C. Robert; Nylander, Per-Olof

doi:10.1111/j.1399-5618.2004.00101.x

Cited by 72 publications

(48 citation statements)

References 43 publications

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“…In the group of suicide attempters, we found significantly higher scores on HA and significantly lower scores in SD, CO, and PS when compared to the non-suicidal group. Previous studies found results somewhat similar to ours, i.e., higher HA and lower SD in the group of patients with mood disorders who had suicide attempt (see Woo et al 2014, Brezo et al 2006, Engstrom et al 2004). Higher HA, defined as a tendency to respond intensely to signals or aversive stimuli, may be state-dependent personality trait in depressive states (Pelissolo & Corruble 2002).…”

Section: Discussionsupporting

confidence: 74%

The Temperament and Character Traits in Patients With Major Depressive Disorder and Bipolar Affective Disorder With and Without Suicide Attempt

Erić

Ćurković

et al. 2017

Psychiat Danub

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Section: Discussionsupporting

confidence: 74%

The Temperament and Character Traits in Patients With Major Depressive Disorder and Bipolar Affective Disorder With and Without Suicide Attempt

Erić

Ćurković

et al. 2017

Psychiat Danub

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“…Confirming the validity of our results, we found that harm avoidance was the only temperament associated with suicide risk. This link has been previously reported as a predisposing factor for suicide (Engstrom et al, 2004).…”

Section: Profile Of Prisoners With a Dd Compared To Other Prisonerssupporting

confidence: 63%

Dual Diagnosis: Prevalence, Risk Factors, and Relationship With Suicide Risk in a Nationwide Sample of French Prisoners

Lukasiewicz

Blecha

Falissard

et al. 2008

Alcoholism Clin & Exp Res

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Background: Axis I psychiatric disorders (PD) and substance use disorders (SUD) are common in prison, but only few studies have focused on their association in this setting. Dual diagnosis (DD) (the co-occurrence of a SUD and any axis I disorder) is known to have a poorer prognosis and to require more intense supportive care.Objectives: The objectives of this study were (1) to describe prisoners with DD (prevalence and characteristics); (2) to compare DD prisoners with 3 other groups of prisoners: no diagnosis (ND), SUD alone, or other isolated PD; and (3) to evaluate the impact of DD on suicide risk in prison.Method: A random stratified strategy was used to select 23 various types of prisons and 998 prisoners. Diagnoses were assessed using a unique procedure, each prisoner being evaluated by 2 psychiatrists, 1 junior, using a structured interview (MINI 5 plus), and 1 senior, using an open clinical interview. Following interviews, clinicians met to establish a list of diagnoses. Cloninger's temperament and character inventory was also used.Results: Of the prisoners, 26.3% had a DD. DD prevalence was almost 80% in prisoners with SUD, while only one-third of the prisoners with an axis I PD had co-morbid SUD. No significant differences were observed in drug use patterns between DD and SUD without co-morbid PDs. DD showed the strongest association with suicide risk [OR = 5.7 (1.7-4.6)].Conclusion: DD is very frequent in prison and is a major risk factor for suicide. Systematic psychiatric ⁄ SUD screening of prisoners with either a SUD or an axis I PD should be encouraged.Abbreviations: DD, prisoners with a dual diagnosis in the last 12 months; ND, prisoners with neither an axis I psychiatric disorder nor a substance use disorder in the last 12 months; PD, prisoners with at least 1 axis I psychiatric disorder in the last 12 months; SUD, substance use disorders or prisoners with at least 1 substance use disorders in the last 12 months; TCI, temperament and character inventory.

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“…When compared to healthy individuals, bipolar patients achieve higher scores on novelty seeking (Young et al, 1995;Osher et al, 1999;Evans et al, 2005), harm avoidance (Young et al, 1995;Osher et al, 1996;Engstrom et al, 2004a;Evans et al, 2005) and reward dependence (Osher et al, 1996), and lower scores on persistence (Osher et al, 1996;Osher et al, 1999) and self-directedness (Engstrom et al, 2004a;Evans et al, 2005). In bipolar disorder, higher scores on harm avoidance were also associated with early onset of disease and fewer suicide attempts (Engstrom et al, 2003;Engstrom et al, 2004b).…”

Section: Introductionmentioning

confidence: 99%

Temperament and character traits in patients with bipolar disorder and associations with comorbid alcoholism or anxiety disorders

Nery

Hatch

Glahn

et al. 2008

Journal of Psychiatric Research

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Temperament and character traits may determine differences in clinical presentations and outcome of bipolar disorder. We compared personality traits in bipolar patients and healthy individuals using the Temperament and Character Inventory (TCI) and sought to verify whether comorbidity with alcoholism or anxiety disorders is associated with specific personality traits. Seventy three DSM-IV bipolar patients were compared to 63 healthy individuals using the TCI. In a second step, the bipolar sample was subgrouped according to the presence of psychiatric comorbidity (alcoholism, n = 10; anxiety disorders; n = 23; alcoholism plus anxiety disorders, n = 21; no comorbidity, n = 19). Bipolar patients scored statistically higher than the healthy individuals on novelty seeking, harm avoidance and self-transcendence and lower on self-directedness and cooperativeness. Bipolar patients with only comorbid alcoholism scored statistically lower than bipolar patients without any comorbidity on persistence. Bipolar patients with only comorbid anxiety disorders scored statistically higher on harm avoidance and lower on self-directedness than bipolar patients without any comorbidity. Limitations of this study include the cross-sectional design and the small sample size, specifically Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. in the analysis of the subgroups. However, our results suggest that bipolar patients exhibit a different personality structure than healthy individuals and that presence of psychiatric comorbidity in bipolar disorder is associated with specific personality traits. These findings suggest that personality, at least to some extent, mediates the comorbidity phenomena in bipolar disorder.

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Bipolar disorder. III: Harm avoidance a risk factor for suicide attempts

Abstract: Age of onset, HA, PS, gender and family history of suicide had a moderate to very strong effect on suicide attempts in bipolar patients.

Cited by 72 publications

References 43 publications

The Temperament and Character Traits in Patients With Major Depressive Disorder and Bipolar Affective Disorder With and Without Suicide Attempt

The Temperament and Character Traits in Patients With Major Depressive Disorder and Bipolar Affective Disorder With and Without Suicide Attempt

Dual Diagnosis: Prevalence, Risk Factors, and Relationship With Suicide Risk in a Nationwide Sample of French Prisoners

Temperament and character traits in patients with bipolar disorder and associations with comorbid alcoholism or anxiety disorders

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