Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review

Berardis, Domenico De; Fornaro, Michele; Orsolini, Laura; Valchera, Alessandro; Carano, Alessandro; Vellante, Federica; Perna, Giampaolo; Serafini, Gianluca; Gonda, Xénia; Pompili, Maurizio; Martinotti, Giovanni; Giannantonio, Massimo Di

doi:10.3389/fpsyt.2017.00148

Cited by 131 publications

(110 citation statements)

References 56 publications

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“…If the functional purposes that drive self-injury do serve as some indication of particular suicide risk, it might be also relevant to look at the particular intrapersonal factors which predict use of NSSI for different functional purposes-the goal of our previous study [40]. There, alexithymia emerged as a variable of particular interest in self-injury [40], perhaps unsurprisingly given its links to self-injury and suicidality in the general population [70,71]. Alexithymia was particularly associated with the use of NSSI by autistic people to regulate high-energy states such as agitation, anxiety, and anger-but notably, the present analysis showed that engagement in NSSI for this purpose was not associated with increased suicidality.…”

Section: Discussionmentioning

confidence: 99%

Links between self-injury and suicidality in autism

et al. 2020

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Background: Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method: One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/ attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. Results: While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions: These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

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Section: Discussionmentioning

confidence: 99%

Links between self-injury and suicidality in autism

et al. 2020

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“…In addition, it should be noted that our review focused only on a limited set of variables, while other individual/clinical factors, relatively easy to assess in clinical practice, may play a role, such as childhood maltreatment/adversities, [124][125][126] inflammatory markers, 127,128 other symptom profiles or individual features. Among the latter, alexithymia, reflecting difficulty with identifying and expressing emotions, seems to be associated with higher severity of depression, increased suicide risk, and pro-inflammatory imbalance; [129][130][131][132][133] thus its potential contribute to selection of specific antidepressant class/compound may be worth investigating. Finally, we did not include combined pharmacotherapies, augmentation strategies, or non-pharmacological interventions.…”

Section: Discussionmentioning

confidence: 99%

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Perna

Alciati²,

Daccò

et al. 2020

Psychiatry Investig

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Despite several pharmacological options, the clinical outcomes of major depressive disorder (MDD) are often unsatisfactory. Personalized psychiatry attempts to tailor therapeutic interventions according to each patient’s unique profile and characteristics. This approach can be a crucial strategy in improving pharmacological outcomes in MDD and overcoming trial-and-error treatment choices. In this narrative review, we evaluate whether sociodemographic (i.e., gender, age, race/ethnicity, and socioeconomic status) and clinical [i.e., body mass index (BMI), severity of depressive symptoms, and symptom profiles] variables that are easily assessable in clinical practice may help clinicians to optimize the selection of antidepressant treatment for each patient with MDD at the early stages of the disorder. We found that several variables were associated with poorer outcomes for all antidepressants. However, only preliminary associations were found between some clinical variables (i.e., BMI, anhedonia, and MDD with melancholic/atypical features) and possible benefits with some specific antidepressants. Finally, in clinical practice, the assessment of sociodemographic and clinical variables considered in our review can be valuable for early identification of depressed individuals at high risk for poor responses to antidepressants, but there are not enough data on which to ground any reliable selection of specific antidepressant class or compounds. Recent advances in computational resources, such as machine learning techniques, which are able to integrate multiple potential predictors, such as individual/ clinical variables, biomarkers, and genetic factors, may offer future reliable tools to guide personalized antidepressant choice for each patient with MDD.

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“…145 Similarly, the alexithymia construct applied to MDD subjects, seemed to demonstrate a correlation between alexithymia traits, MDD severity and increased risk of SI and more severe SA. 146,147…”

Section: Temperament Character and Personality Traitsmentioning

confidence: 99%

Understanding the Complex of Suicide in Depression: from Research to Clinics

Orsolini

Latini²,

Pompili³

et al. 2020

Psychiatry Investig

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253

167

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Objective Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15–17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians.Methods A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of ‘Major Depressive Disorder’ and ‘Suicide’ as following: ((<i>suicide</i> [Title/Abstract]) AND (<i>major depressive disorder</i> [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way.Results Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators.Conclusion The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.

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Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review

Cited by 131 publications

References 56 publications

Links between self-injury and suicidality in autism

Links between self-injury and suicidality in autism

Personalized Psychiatry and Depression: The Role of Sociodemographic and Clinical Variables

Understanding the Complex of Suicide in Depression: from Research to Clinics

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