A recent suicide attempt and the heartbeat: Electrophysiological findings from a trans-diagnostic cohort of patients and healthy controls

Rüesch, Annia; Araujo, Tania Villar de; Bankwitz, Anna; Hörmann, Christoph; Adank, Atalìa; Ip, Cheng-Teng; Schoretsanitis, Georgios; Kleim, Birgit; Olbrich, Sebastian

doi:10.1016/j.jpsychires.2022.11.020

Cited by 6 publications

(4 citation statements)

References 61 publications

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“…Such results are in line with several previous studies. For example, Rüesch et al, (Rüesch et al, 2022) found that they could distinguish psychiatric inpatients with a recent suicidal attempt from others by their elevated SNS activity and lowered PNS activity. Sheridan et al, (Sheridan et al, 2021), found that severely suicidal adolescents had lowered PNS activity that could be detected by wearable devices, and suggested monitoring suicidal patients for PNS activity in order to protect them from suicidal behavior.…”

Section: Discussionmentioning

confidence: 99%

Implicit Measures of Extreme Psychological Distress in Young Healthy Adults: Cardiac Autonomic Activity and Attentional Bias

H. Zohar,

Levi-Belz,

Linetzky

2023

PSYCH

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Background: There is research showing that cardiac sympathetic autonomous activity is elevated and cardiac parasympathetic autonomous activity is decreased in individuals contending with serious psychopathology. There is also work showing that attentional bias to emotionally distressing stimuli is affected by depression and anxiety. This study hypothesized that individuals who were high on suicide-related attention bias (AB) and cardiac sympathetic activity (SNS index) would also have elevated psychological distress, even in the absence of a diagnosable disorder. Methods: Participants were 181 healthy college students, 42.5% male. Personality traits, depression, hopelessness and suicidal ideation/behaviour were self-reported. Cardiac activity was measured using bodyguard2, and the SNS index was used as a measure of stress. AB was measured using stimuli salient in the context of death and suicide. Results: Correlations were in the expected direction. Cluster analysis using AB and the SNS index produced three clusters, of which Cluster 3, 19.7% of the sample, had elevated AB and SNS index, and by far the most distressed psychological profile, above the clinical cut-off point for depression. Conclusions: The study results indicate a strong association between objective and subjective measures of distress uncovered by cluster analysis. Such result may help to identifying a group of extremely distressed individuals among healthy adults. Individuals with a distressed personality profile, who are depressed and reject life, can be distinguished by their cardiac stress and AB.

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Section: Discussionmentioning

confidence: 99%

Implicit Measures of Extreme Psychological Distress in Young Healthy Adults: Cardiac Autonomic Activity and Attentional Bias

H. Zohar,

Levi-Belz,

Linetzky

2023

PSYCH

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“…Concerning SA, a previous study showed lower resting HF-HRV in women with than without history of SA, even after adjusting for history of psychiatric disorders and current depressive or anxiety symptomatology [ 23 ]. Another study showed that resting HF-HRV and RMSSD were significantly lower in the patient group (n = 52 inpatients with a recent suicide attempt, < 6 months, and various psychiatric comorbidities) than in healthy controls (n = 43) [ 24 ]. Moreover, during the Trier Social Stress Test (TSST), HRV reactivity was lower in women with SA than in control patients [ 25 ].…”

Section: Autonomous Nervous System Biomarkers and Suicidalitymentioning

confidence: 99%

From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior

Alacreu-Crespo,

Sebti,

Moret

et al. 2024

Curr Psychiatry Rep

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Purpose of Review In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors. Recent Findings Patients with suicidal ideation/suicide attempt have higher sympathetic nervous system (SNS) and lower parasympathetic nervous system (PNS) activity in resting conditions and during acute stress tasks compared with patients without suicidal ideation/suicide attempt. Death by suicide and violent suicide attempt also are related to SNS hyperactivation. Similarly, a SNS/PNS imbalance has been observed in people with childhood trauma, stressful life events or feelings of loneliness and isolation. Social support seems to increase PNS control and resilience. Summary Due to the importance of the social context and stressful life events in suicidal behavior, SNS/PNS imbalance could act as a mediator in this relationship and be a source of relevant biomarkers. Childhood trauma and stressful life events may impair the autonomic nervous system response in suicidal patients. Loneliness, isolation and social support may act as moderators in acute stress situations.

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“…This last study suggests that, in the Norwegian cohort, the association between resting heart rate and suicide remained after adjustment for anxiety and depression. For nonfatal suicide attempts (SA), however, preliminary results show contrasting observations such as high (Ruesch et al, 2023) versus low (Tsypes et al, 2018) resting heart rate in patients with a history of SA compared to controls.…”

Section: Introductionmentioning

confidence: 98%

“…Suicidal thoughts and behaviors are central public health concerns, related to both internalizing and externalizing traits (Soto-Sanz et al, 2019), with externalizing symptomatology allowing a distinction between individuals who have suicidal ideation from those who attempt suicide (Commisso et al, 2021). Though recent studies underscore the possible utility of cardiac markers to predict suicidal behavior (Adolph et al, 2018;Kang et al, 2020;Ruesch et al, 2023), very few studies have investigated the predictive role of resting heart rate. Findings suggest an association between elevated resting heart rate and nonsuicidal self-injury in adolescents (Nelson et al, 2023) as well as proximal suicide risk among patients with internalizing disorders (Lee et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

A Swedish population‐based study to evaluate the usefulness of resting heart rate in the prediction of suicidal behavior among males

Lannoy,

Ohlsson,

Sundquist

et al. 2024

Suicide & Life Threat Behav

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IntroductionResting heart rate has been distinctly related to both internalizing (high pulse) and externalizing (low pulse) disorders. We aimed to explore the associations between resting heart rate and suicidal behavior (nonfatal suicide attempt [SA] and suicide death [SD]) and evaluate if such associations exist beyond the effects of internalizing/externalizing symptomatology.MethodWe used Cox proportional hazards models to evaluate the associations between resting heart rate (age 19) and later SA/SD in 357,290 Swedish men. Models were controlled for internalizing disorders, externalizing disorders, and resilience (the ability to deal with adversity). Co‐relative analysis (comparing pairs of different genetic relatedness) was used to control for unmeasured family confounders and improve causal inference.ResultsIn baseline models, low resting heart rate was associated with SA (HR = 0.96; 95% CI: 0.95,0.98) and high resting heart rate with SD (HR = 1.04; 95% CI: 1.002,1.07). The association with SA remained after adjustment for all confounders (HR = 0.98). However, the association with SD did not persist after controlling for covariates. Co‐relative analysis did not support causal associations.ConclusionsOur findings raise interesting etiological questions for the understanding of suicidal behaviors but do not support the usefulness of resting heart rate in suicide prediction.

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A recent suicide attempt and the heartbeat: Electrophysiological findings from a trans-diagnostic cohort of patients and healthy controls

Cited by 6 publications

References 61 publications

Implicit Measures of Extreme Psychological Distress in Young Healthy Adults: Cardiac Autonomic Activity and Attentional Bias

Implicit Measures of Extreme Psychological Distress in Young Healthy Adults: Cardiac Autonomic Activity and Attentional Bias

From Social Stress and Isolation to Autonomic Nervous System Dysregulation in Suicidal Behavior

A Swedish population‐based study to evaluate the usefulness of resting heart rate in the prediction of suicidal behavior among males

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