Suicidal disorders: A nosological entity per se?

Leboyer, Marion; Slama, Frédéric; Siever, Larry J.; Bellivier, Frank

doi:10.1002/ajmg.c.30040

Cited by 33 publications

(22 citation statements)

References 51 publications

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“…In addition, the correlation between the suicidality and internalizing factors was relatively large (0.61), but it was not large enough to suggest that both factors are measuring the same concept. This finding is consistent with the perspective that suicidal behavior is itself a valid clinical syndrome that cooccurs with other forms of psychopathology (Ahrens and Linden 1996;Leboyer et al 2005). …”

Section: Discussion Summarysupporting

confidence: 90%

“…Consequently, it has been argued that psychopathology is a necessary, but not sufficient, condition for suicidal behavior (Apter and Ofek 2001). It has also been suggested that suicidal behavior is itself a valid clinical syndrome that co-occurs with other forms of psychopathology (Ahrens and Linden 1996;Leboyer et al 2005). Moreover, family genetic studies that suggest that suicidality is transmitted independent of psychopathology (Brent and Mann 2005;Turecki 2001).…”

Section: Suicidalitymentioning

confidence: 99%

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A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

Yoder

Longley

Whitbeck

et al. 2007

J Abnorm Child Psychol

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The present study examined associations among dimensions of suicidality and psychopathology in a sample of 428 homeless adolescents (56.3% female). Confirmatory factor analysis results provided support for a three-factor model in which suicidality (measured with lifetime suicidal ideation and suicide attempts), internalizing disorders (assessed with lifetime diagnoses of major depressive episode and post-traumatic stress disorder), and externalizing disorders (indicated by lifetime diagnoses of conduct disorder, alcohol abuse, and drug abuse) were positively intercorrelated. The findings illustrate the utility of a dimensional approach that integrates suicidality and psychopathology into one model. KeywordsPsychopathology; Suicidality; Internalizing; Externalizing; Homeless adolescents Dimensions of adolescent suicidality and psychopathology are of increased concern to clinicians and researchers (Bridge et al. 2006;Verona et al. 2004). This interest can be attributed to the relatively high prevalence of adolescent suicidal ideation and suicide attempts (Evans et al. 2005) and to suicide being the third leading cause of death among youths ages 15-24 in the USA (Hoyert et al. 2006). Research also indicates both suicidal ideation and suicide attempts increase the risk for completed suicide (Brown et al. 2000). This pattern of increased liability for suicide risk has led to a broader conceptualization of a suicide spectrum ranging from suicidal ideation to attempted and completed suicide (Lewinsohn et al. 1996).Moreover, psychiatric disorders are among the strongest correlates of adolescent suicidality (Bridge et al. 2006). Mood disorders are robust correlates, but post-traumatic stress disorder, conduct disorder, and substance use disorders are also associated with suicidality (Bridge et al. 2006;Evans et al. 2004). Krueger (1999), informed by the work of Achenbach (Achenbach and McConaughy 1997), developed a dimensional model of psychopathology and clustered psychiatric diagnoses into internalizing and externalizing disorders. As specific psychiatric disorders from both clusters are related to suicidal ideation and attempts, there is interest in linking the suicide spectrum to these broader dimensions of psychopathology (Hills et al. 2005;Verona et al. 2004).Our study expands on this work by including the internalizing and externalizing dimensions of psychopathology in a structural model of adolescent suicidality using a sample of homeless adolescents. Suicidality is measured with lifetime suicidal ideation and suicide attempts, internalizing psychopathology with lifetime diagnoses of major depressive episode and posttraumatic stress disorder, and externalizing psychopathology with lifetime diagnoses of conduct disorder, alcohol abuse, and drug abuse. We use confirmatory factor analysis to examine covariances among dimensions of suicidality, internalizing, and externalizing disorders. Internalizing and Externalizing DisordersAchenbach used an empirical approach to derive two broad dimensions (internalizing...

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Section: Discussion Summarysupporting

confidence: 90%

Section: Suicidalitymentioning

confidence: 99%

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

Yoder

Longley

Whitbeck

et al. 2007

J Abnorm Child Psychol

View full text Add to dashboard Cite

show abstract

“…8,9 Although the exact clinical definition of suicidal behaviour remains unsatisfactory and is a source of confusion, the phenomenon of suicidality is often viewed as occurring on a continuum of increasing severity from ideation over attempts to completed suicide 10 and may be classified according to the intent to die, method and lethality (violent or non-violent), cognitive impairments (impulsivity, aggressiveness), or mitigating circumstances. 11 The method of suicide is not randomly distributed. For example, violent methods, assessed with a higher level of lifetime aggression and a higher level of impulsivity, are more often applied by males than by females.…”

Section: Introductionmentioning

confidence: 99%

Genetics of suicide

2006

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The concept that genetic factors contribute to the complex trait of suicidal behaviour has stimulated much work aimed at identifying susceptibility genes. So far molecular genetic studies focused on the serotonergic pathway as the intent to die and the lethality of suicide acts were related to the serotonergic system. Two genes have so far emerged as being involved in the vulnerability for suicidality: first, the intronic polymorphisms (A218C or A779C) of the tryptophan hydroxylase 1 (TPH1) gene, which was suggested as a quantitative risk factor for suicidal behaviour; second, the insertion/deletion polymorphism of the serotonin transporter gene (5-HTTLPR), which does not seem to be involved in general suicidal behaviour, but in violent and repeated suicide attempts. The data have further shown that the MAOA gene, which is consistently associated with impulsive-aggressive personality traits, is not related to suicide but might induce violent methods in subjects with other suicide risk factors. Predominantly negative were the findings with any type of the serotonin receptors and inconsistent with catecholamine-synthesizing and -metabolizing enzymes or with the dopaminergic receptors. This paper reviews the status of current knowledge in this area, points to the weakness of the investigations and presents new approaches beyond the serotonergic system.

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“…Suicidal behavior is an important and grave social problem with complex and intricate clinical implications which might constitute the fi nal outcome of several psychiatric conditions (although it may also be an existential choice, in some cases) (Leboyer et al 2005). Among the neurotransmitters associated with neuropsychiatric disorders, noradrenaline and serotonin are closely associated with depression and suicide.…”

Section: O R I G I N a L R E S Ementioning

confidence: 99%

Increased mRNA expression of cytochrome oxidase in dorsal raphe nucleus of depressive suicide victims

Sánchez-Bahillo

Bautista-Hernández²,

Gonzalez³

et al. 2008

NDT

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Suicidal behavior is a problem with important social repercussions. Some groups of the population show a higher risk of suicide; for example, depression, alcoholism, psychosis or drug abuse frequently precedes suicidal behavior. However, the relationship between metabolic alterations in the brain and premorbid clinical symptoms of suicide remains uncertain. The serotonergic and noradrenergic systems have frequently been, implicated in suicidal behavior and the amount of serotonin in the brain and CSF of suicide victims has been found to be low compared with normal subjects. However, there are contradictory results regarding the role of noradrenergic neurons in the mediation of suicide attempts, possibly refl ecting the heterogeneity of conditions that lead to a common outcome. In the present work we focus on the subgroup of suicide victims that share a common diagnosis of major depression. Based on post-mortem studies analyzing mRNA expression by in situ hybridization, serotonergic neurons from the dorsal raphe nucleus (DRN) from depressive suicide victims are seen to over-express cytochrome oxidase mRNA. However, no corresponding changes were found in the expression of tyrosine hydroxylase (TH) mRNA in the noradrenergic neurons of the Locus Coeruleus (LC). These results suggest that, despite of the low levels of serotonin described in suicide victims, the activity of DRN neurons could increase in the suicidally depressed, probably due to the over activation of serotonin re-uptake. No alteration was found in noradrenergic neurons, suggesting that they play no crucial role in the suicidal behavior of depressive patients.

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Suicidal disorders: A nosological entity per se?

Cited by 33 publications

References 51 publications

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

Genetics of suicide

Increased mRNA expression of cytochrome oxidase in dorsal raphe nucleus of depressive suicide victims

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