Alterations in circadian/seasonal rhythms and vegetative functions are related to suicidality in DSM-5 PTSD

Abstract

BackgroundAlterations in rhythmicity and vegetative functions have been reported as correlates of suicidality, particularly in patients with mood disorders. No investigation has addressed their impact on patients with post-traumatic stress disorder (PTSD). Aim of the present study was to fulfill this gap.MethodsSixty-five out- and inpatients with DSM-5 PTSD were assessed by using the Mood Spectrum-Self Report-Lifetime Version (MOODS-SR), a questionnaire for lifetime mood spectrum symptomatology including alterations in circadian/seasonal rhythms and vegetative functions. Six items of the MOODS-SR were combined and dichotomized to assess suicidal ideation and/or attempts.ResultsSignificant and positive associations were found between symptoms of lifetime dysregulations in rhythmicity and vegetative functions and suicidal ideation and/or attempts. All MOODS-SR sub-domains (rhythmicity, sleep, appetite/weight, sexual function, physical symptoms) were associated with an increased likelihood of suicidal ideation, but only changes in appetite/weight were associated with greater odd ratios of suicide attempts (OR = 2.099, 95% CI 1.148-3.841).ConclusionsOur results suggest that lifetime dysregulations in rhythmicity and vegetative functions may represent correlates of suicidality in patients with DSM-5 PTSD.

The Relationship Between Sleep Disturbance, Suicidal Ideation, Suicide Attempts, and Suicide Among Adults: A Systematic Review

“…37 In a smaller sample of both inpatient and outpatient participants, results of patients with PTSD with both a sleep rhythmicity subscale (with higher values indicting greater rhythmicity problems) and a sleep disturbance scale were associated with SI; only rhythmicity remained significant in regression models. 38 Among inpatient and outpatient participants in substance abuse programs in Poland, insomnia severity over a 1-month period followed by a 6-month period was associated with SI in unadjusted models and "past month insomnia" severity remained significant in models adjusting for psychopathology. 41 Among 44 inpatient participants with recurrent depressive disorder, the presence of nightmares was associated with suicide risk from a depression scale; no such findings were observed in eight patients with bipolar disorder.…”

Short Sleep Duration and Circadian Rhythms: Association with Suicidal Behaviour

“…In 4 of these studies, a significant increase in suicide risk was found for the evening-type chronotype [3,[47][48][49].…”

“…The study conducted by Dell' Osso et al with post-traumatic stress disorder patients [49] showed an association of sleep rhythmicity dysregulations with suicidal ideation, but not with suicide attempts. The nature of the associations was maintained after adjusting for depression.…”

“…Among the 6 studies in adults, 3 of them performed a cross-sectional analysis of chronotype and the presence of suicidal behaviours [47][48][49], 2 were case-control studies [10,24], and 1 was a retrospective study [3]. In 4 of these studies, a significant increase in suicide risk was found for the evening-type chronotype [3,[47][48][49].…”

“…The results were slightly more consensual for adolescents than for adults. In this last group, the studies that found a significant relation were conducted in individuals with psychiatric disorders (depression [48], post-traumatic stress disorder [49], bipolar disorder [47]) or in suicide victims [3], whereas both studies with a non-significant association were case-control studies comparing suicide victims with controls [10] or patients with major depression and controls [24].…”