Gambling in patients with major depressive disorder is associated with an elevated risk of Suicide: Insights from 12-years of Nationwide inpatient sample data

Jolly, Taranjeet; Trivedi, Chintan; Adnan, Mahwish; Mansuri, Zeeshan; Agarwal, Vishesh

doi:10.1016/j.addbeh.2021.106872

Cited by 14 publications

(18 citation statements)

References 33 publications

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“…Collectively, STB has been associated with deficits in cognitive control (Richard-Devantoy et al, 2014) and impaired probabilistic learning in the context of rewards and punishments, including impaired delay discounting (Bridge et al, 2015), impaired reversal learning (Dombrovski et al, 2010) and impaired value comparison during the choice process (Dombrovski et al, 2019); for recent reviews see Lalovic et al (2022) and Sastre-Buades et al (2021). Outside of the laboratory, this is corroborated by findings of heightened suicide risk in gambling disorders (Karlsson and Håkansson, 2018;Jolly et al, 2021). Behavioral insensitivity to adverse consequences and heightened sensitivity to internal emotional states have also been linked to suicide attempts (Szanto et al, 2014).…”

Section: Introductionmentioning

confidence: 94%

A Computational Model of Hopelessness and Active-Escape Bias in Suicidality

Karvelis

Diaconescu

2022

Computational Psychiatry

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Currently, psychiatric practice lacks reliable predictive tools and a sufficiently detailed mechanistic understanding of suicidal thoughts and behaviors (STB) to provide timely and personalized interventions. Developing computational models of STB that integrate across behavioral, cognitive and neural levels of analysis could help better understand STB vulnerabilities and guide personalized interventions. To that end, we present a computational model based on the active inference framework. With this model, we show that several STB risk markers -hopelessness, Pavlovian bias and active-escape bias -are interrelated via the drive to maximize one's model evidence. We propose four ways in which these effects can arise: (1) increased learning from aversive outcomes, (2) reduced belief decay in response to unexpected outcomes, (3) increased stress sensitivity and (4) reduced sense of stressor controllability. These proposals stem from considering the neurocircuits implicated in STB: how the locus coeruleus -norepinephrine (LC-NE) system together with the amygdala (Amy), the dorsal prefrontal cortex (dPFC) and the anterior cingulate cortex (ACC) mediate learning in response to acute stress and volatility as well as how the dorsal raphe nucleus -serotonin (DRN-5-HT) system together with the ventromedial prefrontal cortex (vmPFC) mediate stress reactivity based on perceived stressor controllability. We validate the model by simulating performance in an Avoid/ Escape Go/No-Go task replicating recent behavioral findings. This serves as a proof of concept and provides a computational hypothesis space that can be tested empirically and be used to distinguish planful versus impulsive STB subtypes. We discuss the relevance of the proposed model for treatment response prediction, including pharmacotherapy and psychotherapy, as well as sex differences as it relates to stress reactivity and suicide risk.

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Section: Introductionmentioning

confidence: 94%

A Computational Model of Hopelessness and Active-Escape Bias in Suicidality

Karvelis

Diaconescu

2022

Computational Psychiatry

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“…However, for interventions at the individual and aggregate level, secondary outcomes included mental health symptoms and wellbeing. While problematic gambling can be accompanied by significant financial strain (often concealed from, or at the detriment to, close relationships) and is associated with both depressive symptoms and suicidality [e.g., (13)(14)(15)], this was considered outside the scope and purpose of the current review. Therefore, any study with a primary focus on the relationship between gambling and suicidal behaviors or ideation and/or interventions addressing problematic gambling to prevent suicidal behaviors or ideation were excluded.…”

Section: Selection and Prioritization Of Studiesmentioning

confidence: 99%

The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review

Mathieu

Treloar

Hawgood

et al. 2022

Front. Public Health

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Understanding the social determinants and risk factors for suicidal behaviors underlies the development of effective suicide prevention interventions. This review focused on recently published literature (2010 onwards), with the aim to determine the role of economic factors (at the individual and population level) on suicidal behaviors and ideation as well as the effectiveness of interventions addressing these factors in reducing suicidal behaviors and ideation. Where available, literature examining the economic impact of COVID-19 was highlighted. Economic recession and unemployment are associated with increased risk of suicidal behavior at the population and individual level. Additionally, personal financial problems such as debt and financial strain are associated with increased risk of suicidal behavior and ideation at the individual level. Regarding interventions, unemployment benefits, employment protection legislation, higher minimum wage and active labor market programs may reduce suicide at the population level. However, it is not clear what impact they have at the individual level, nor in relation to suicide attempts, self-harm, or suicidal ideation. There was a lack of evidence as to the effectiveness of financially focused suicide prevention interventions at either level. Current findings were contextualized within, and advance, prominent social theoretical models. Recommendations focused on future areas of research, including the unfolding economic impact of COVID-19, as well as the co-design and evaluation of tailored interventions and/or gatekeeper training for those in the financial and welfare sector, and enhanced early education aimed at increasing financial literacy in young people before onset or exacerbation of financial hardship.

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“…Besides, good social support is important to maintain a good emotional experience. [ 29 ] It is reported that patients with depression lack a complete social support system. When they are depressive, they cannot get outside support well or cannot make effective use of support.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care

Xu¹,

Sun²

2022

Medicine

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The incidence of suicide in patients with depressive order is much higher than other population. We aimed to evaluate the current status and risk of suicidal attempt in patients with the melancholic subtype of depressive disorder, to provide evidence for the clinical management and nursing care of depressive disorder. Patients diagnosed as the melancholic subtype of depressive disorder and treated in our hospital from June 1, 2018 to August 31, 2021 were included. The characteristics of included patients were collected and analyzed. Pearson correlation analysis and logistic regression analysis with odd ratio and 95% confidence interval were conducted to analyze the influencing factors of suicidal attempt in patients with the melancholic subtype of depressive disorder. A total of 446 patients with melancholic subtype of depressive disorder were included, the incidence of suicidal attempt was 18.83%. Pearson correlation analysis indicated that gender ( R = 0.611), alcohol drinking ( R = 0.719), living situation ( R = 0.812), number of previous admission to hospital ( R = 0.547), sleep disorder ( R = 0.612) and frequent depressive episodes ( R = 0.559) were all correlated with the suicidal attempt in patients with melancholic subtype of depressive disorder (all P < 0.05). Logistic regression analysis showed that female (OR 3.115, 95%CI 2.493–3.906), alcohol drinking(OR 1.946, 95%CI 1.684–2.763), living alone (OR 2.401, 95%CI 1.915–3.008), number of previous admission to hospital ≥ 3 (OR 2.342, 95%CI 1.601–2.742), sleep disorder (OR 1.821, 95%CI 1.328–2.215) and frequent depressive episodes (OR 3.128, 95%CI 2.421–3.779) were the independent risk factors of suicidal attempt (all P < 0.05). Suicidal attempt is common in the patients with melancholic subtype of depressive disorder, and there are many related risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder.

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Gambling in patients with major depressive disorder is associated with an elevated risk of Suicide: Insights from 12-years of Nationwide inpatient sample data

Cited by 14 publications

References 33 publications

A Computational Model of Hopelessness and Active-Escape Bias in Suicidality

A Computational Model of Hopelessness and Active-Escape Bias in Suicidality

The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review

Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care

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