Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two‐year prospective study

Ducasse, Déborah; Jaussent, Isabelle; Guillaume, Sébastien; Azorin, Jean‐Michel; Bellivier, Frank; Belzeaux, Raoul; Bougerol, Thierry; Étain, Bruno; Gard, Sébastien; Henry, Chantal; Kahn, Jean‐Pierre; Leboyer, Marion; Loftus, J.; Passerieux, Christine; Olié, Émilie; Courtet, Philippe

doi:10.1111/acps.12710

Cited by 20 publications

(15 citation statements)

References 65 publications

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“…Findings of this report are consistent with the emerging literature linking anger to suicidality (Ducasse et al, 2017; Hogstedt et al, 2018; Start et al, 2019). In a recent report, Hogstedt et al (2018) found that likelihood of completed suicide and suicide attempts over a 35‐year follow‐up were 2.1 and 2.8 times higher in male Swedish conscripts with severe anger symptoms versus those with no anger symptoms at index visit.…”

Section: Discussionsupporting

confidence: 91%

“…Findings of this report are consistent with the emerging literature linking anger to suicidality (Ducasse et al, 2017;Hogstedt et al, 2018;Start et al, 2019). In a recent report, Hogstedt et al (2018) found that likelihood of completed suicide and suicide attempts over with fivefold greater likelihood of reporting SI (categorized as score ≥2 on suicide-related item of the 9-item Patient Health Questionnaire) (Start et al, 2019).…”

supporting

confidence: 87%

“…Crosssectional studies have reported significant association between anger and suicidality in community samples (Jang et al, 2014) including in home-dwelling elderly (Zhang et al, 2017), in veterans (Wilks et al, 2019), and in patients with chronic cancer pain (Racine et al, 2017), somatoform disorders (Kampfer et al, 2016), and mood or anxiety disorders (Stringer et al, 2013). Similarly, longitudinal studies have also reported an association between the presence of anger at index visit and subsequent suicidal ideation (SI), suicide attempt, or completed suicide (Ducasse et al, 2017;Hogstedt et al, 2018;Start et al, 2019). These findings of association between anger and suicidality are consistent with the previously reported association of constructs related to anger such as irritability (Conner et al, 2004;Orri, Galera, et al, 2018;Orri, Perret, et al, 2018;Orri et al, 2019;Pickles et al, 2009) and aggression (Fanning et al, 2016;McCloskey & Ammerman, 2018) with suicidality.…”

Section: Introductionmentioning

confidence: 99%

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Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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Background: This report evaluates whether anger attacks (sudden uncharacteristic bouts of anger that are associated with autonomic arousal and/or aggression) in patients with major depressive disorder (MDD) are associated with elevated suicidal ideation (SI; active suicidal thoughts and plans). Methods: Participants of Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study who completed Massachusetts General Hospital Anger Attack Questionnaire (AAQ) at baseline were included (n = 293). Levels of SI (suicidal thoughts factor of Concise Health Risk Tracking) were compared at baseline with generalized linear models, and during Stage 1 (baseline-to-week-8) and Stage 2 (week-8-to-week-16) with repeated-measures mixed model analyses. Covariates included age, sex, race, ethnicity, site, and treatment arm. Results: At baseline, participants with (n = 109) versus without anger attacks (n = 184) had higher levels of SI (Cohen's d effect size [d] = 1.20). Those with ≥9 anger attacks in the past month had significantly higher SI than those with 1-2 (d = 1.21), 3-4 (d = 1.48), and 5-8 (d = 0.94) anger attacks in the past month. Furthermore, participants with anger attacks at baseline reported higher SI at each post-baseline visit (both Stages 1 and 2) of EMBARC study (d = 0.39-0.77; all p < .05). Associations between anger attacks and SI were significant even after controlling for irritability, hostility, anxious arousal, depression, suicide propensity, and self-reported pain at baseline and lifetime suicidal tendencies. Similar results were found in participants with aggressive behaviors. Conclusion: Anger attacks in outpatients with MDD may be associated with chronically elevated SI.

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Section: Discussionsupporting

confidence: 91%

“…Findings of this report are consistent with the emerging literature linking anger to suicidality (Ducasse et al, 2017;Hogstedt et al, 2018;Start et al, 2019). In a recent report, Hogstedt et al (2018) found that likelihood of completed suicide and suicide attempts over with fivefold greater likelihood of reporting SI (categorized as score ≥2 on suicide-related item of the 9-item Patient Health Questionnaire) (Start et al, 2019).…”

supporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

View full text Add to dashboard Cite

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“…Moreover, the rapid effects of antidepressants on emotional processing are seen in euthymic subjects as well as in those with depression; similarly, new treatments for BD, such as novel VGCC-acting drugs, could be screened in patients who have unstable mood but who do not have a formal diagnosis. Second, stabilisation of mood may be beneficial in its own right, above and beyond simply preventing clinical episodes of depression and mania, because mood instability independently predicts poor functional recovery in BD, and worse outcomes of various kinds [76,[82][83][84]. In addition, since mood instability often occurs before the onset of BD [85,86], such treatments might have a preventative role.…”

Section: Persistent Mood Instabilitymentioning

confidence: 99%

The Emerging Neurobiology of Bipolar Disorder

Harrison¹,

Geddes²,

Tunbridge³

2019

FOC

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Bipolar disorder (BD) is a leading cause of global disability. Its biological basis is unknown, and its treatment unsatisfactory. Here, we review two recent areas of progress. First, the discovery of risk genes and their implications, with a focus on voltage-gated calcium channels as part of the disease process and as a drug target. Second, facilitated by new technologies, it is increasingly apparent that the bipolar phenotype is more complex and nuanced than simply one of recurring manic and depressive episodes. One such feature is persistent mood instability, and efforts are underway to understand its mechanisms and its therapeutic potential. BD illustrates how psychiatry is being transformed by contemporary neuroscience, genomics, and digital approaches. Bipolar Disorder and the New Psychiatry Psychiatry still relies largely on 19th-Century diagnostic categories. These are based on clusters of symptoms rather than biological markers, and are treated with drugs discovered serendipitously several decades ago. BD typifies this unsatisfactory state of affairs. Although its name has changed [it was formerly known as manic depression (see Glossary)], its cardinal features, and how it is assessed and treated (Box 1) have barely altered. An important reason for this stagnation has been the lack of any real traction on its causes and underlying biology, beyond its well-established high heritability [1]. Although there is evidence for altered structural and functional brain connectivity [2-4], and changes in markers of oxidative stress [5], mitochondrial function [6], inflammation [7], circadian rhythms [8], and dopamine [9], it remains difficult to integrate these diverse findings, and to disentangle causative changes from those that are secondary to the disorder and its treatment. The situation is belatedly improving. While optimism must be tempered by appreciation of the many complexities, there are realistic prospects for a transformation in our understanding of BD and how it is diagnosed and treated. Here, we highlight two areas of current interest: the discovery of the first BD risk genes and their implications, and the application of novel technologies with the potential to refine, or redefine, the BD phenotype. These developments exemplify how genomics, neuroscience, and digital technologies are heralding a new era for psychiatry. For broader reviews of BD, see [10,11].

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“…Moreover, the rapid effects of antidepressants on emotional processing are seen in euthymic subjects as well as in those with depression; similarly, new treatments for BD, such as novel VGCC-acting drugs, could be screened in patients who have unstable mood but who do not have a formal diagnosis. Second, stabilisation of mood may be beneficial in its own right, above and beyond simply preventing clinical episodes of depression and mania, because mood instability independently predicts poor functional recovery in BD, and worse outcomes of various kinds 76 , 82 , 83 , 84 . In addition, since mood instability often occurs before the onset of BD 85 , 86 , such treatments might have a preventative role.…”

Section: New Approaches To the Bipolar Phenotypementioning

confidence: 99%

The Emerging Neurobiology of Bipolar Disorder

Harrison

Geddes

Tunbridge

2018

Trends in Neurosciences

176

102

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Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two‐year prospective study

Abstract: Reducing affective lability could become a new therapeutic target of suicidal prevention in bipolar disorder.

Cited by 20 publications

References 65 publications

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

The Emerging Neurobiology of Bipolar Disorder

The Emerging Neurobiology of Bipolar Disorder

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