High-lethality of suicide attempts associated with platelet to lymphocyte ratio and mean platelet volume in psychiatric inpatient setting

Aguglia, Andrea; Amerio, Andrea; Asaro, Pietro; Caprino, Matilde; Conigliaro, Claudia; Giacomini, Gabriele; Parisi, Valentina Maria; Trabucco, Alice; Amore, Mario; Serafini, Gianluca

doi:10.1080/15622975.2020.1761033

Cited by 22 publications

(21 citation statements)

References 38 publications

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“…Maes et al (69) found a trend in L-tryptophan levels inversely related to the seasonal variation of violent suicides in the Belgian population. Furthermore, a correlation between peripheral dysfunctions of serotoninergic transmission, assessing metabolic, such as cholesterol and triglycerides, and hematologic, such as platelet-lymphocyte ratio and mean platelet volume, parameters and HLSA was demonstrated by recent findings (55,56). A very recent review on the complex phenomenon of suicidal behaviors, conducted by Mann et al (67) confirmed these findings and concluded that there is deficient serotonin release in HLSA.…”

Section: Discussionmentioning

confidence: 94%

“…The cases of suicide attempts were divided into two subgroups based on the severity of the suicidal behaviors. The term “suicidal lethality” has not yet been defined comprehensively and, in our study, we adopted the concept of lethality as defined by Shneidman's ( 53 ) and Joiner's ( 54 ) criteria even used in recently published reports ( 20 , 21 , 55 , 56 ). Methods of suicide attempt were dichotomized in terms of lethality.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, a HLSA was defined as a suicide attempt that warranted hospitalization for at least 24 h and either treatment in a specialized unit (including intensive care unit, hyperbaric unit, or burn unit), surgery under general anesthesia, or extensive medical treatment (beyond gastric lavage, activated charcoal, or routine neurological observations), including antidotes for drug overdoses, telemetry, or repeated tests or investigations. Conversely, a low-lethality suicide attempt (LLSA) was defined as a suicide attempt that did not meet these criteria ( 20 , 21 , 55 , 56 ).…”

Section: Methodsmentioning

confidence: 99%

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Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

et al. 2021

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This study analyzed the impact of meteorological variables and high-lethality suicide attempts (HLSA) to assess a potential time shift of HLSA affected by climate evolution to predict the suicide attempt cases over different periods of the year. After attempting suicide, 225 subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the psychiatric unit from March 2016 to July 2018. Socio-demographic and clinical characteristics as well as the meteorological variables were collected. The Mann-Kendall test as well as redundancy and cross-correlation analyses were performed to analyze the trends, statistically correlations, and correspondence of the trends, respectively between suicidal behaviors and climatic factors. Sixty-seven (29.8%) committed a HLSA. Our findings indicate a significant association between HLSA and male gender and apparent temperature with a strong correlation of 75% with a phase shift of −1 month. Solar radiation and air pollution (PM2.5) have a positive correlation of 65 and 32%, respectively, with a zero-time lag. Limitations include that the data are limited to a single hospital; psychological factors, or other clinical variables that could be ruled out as a trigger have not been considered. Meteorological variables may not mirror the temperature that the patient is exposed to due to the air conditioning systems. Exploring those environmental factors associated with HLSA in a more detailed manner could lead to early intervention and prevention strategies for such distressing admissions.

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Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

et al. 2021

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“…Since markers of inflammation and dyslipidemia, such as CRP, IL-1, IL-6, TNF-a, and cholesterol levels, have been suggested as etiological risk factors of SI/SB development [ 33 , 34 , 35 , 36 ], the possible association of neuropsychiatric complications with CQ/HCQ, which exert potent anti-inflammatory [ 1 ] /anti-lipidemic properties [ 37 , 38 ] appears paradoxical and suggests that other underlying pathological mechanisms might account for these phenomena ( Figure 1 ). In this regard, CQ and HCQ have been proposed to (i) induce neurochemical interference with calcium signaling in neural cells [ 39 ] as well as disruption of dopamine and acetylcholine homeostasis [ 40 , 41 ], and ultimately precipitating into neuropsychiatric symptoms, including suicide ( Figure 1 ).…”

Section: Discussionmentioning

confidence: 99%

Chloroquine/Hydroxychloroquine Use and Suicide Risk: Hypotheses for Confluent Etiopathogenetic Mechanisms?

Costanza

Placenti

Amerio

et al. 2021

Behavioral Sciences

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Chloroquine (CQ) and hydroxychloroquine (HCQ) are classical anti-malarial and anti-inflammatory treatments, which were used as first-line therapy at the beginning of the 2019 coronavirus disease (COVID-19) pandemic. Besides the emerging data on their lack of efficacy against COVID-19 infection, such treatments have been associated with some severe health concerns, including those of neuropsychiatric nature, such as a possible increase in suicide risk. Here we report a case of a patient with no history of psychiatric illnesses, who abruptly developed depression with melancholic features, severe suicidal ideation (SI), and attempted suicide (SA) shortly after receiving HCQ for his COVID-19 infection. The case was followed by a mini-review of the heterogeneous scientific literature on the hypothetical association between neuropsychiatric symptoms, with a focus on SI and suicidal behavior (SB, including SA and death by suicide), when CQ and HCQ are used in COVID-19, rheumatologic diseases, and malaria settings. Considering the anti-inflammatory properties of CQ and HCQ and the implications for neuroinflammation in suicide pathogenesis, the possible increase in suicide risk caused by these medications appears paradoxical and suggests that other underlying pathological trajectories might account for this eventuality. In this regard, some of these latter mechanistic postulates were proposed. Certainly the role and contribution of psycho-social factors that a COVID-19 patient had to face can neither be minimized nor excluded in the attempt to understand his suffering until the development of SI/SB. However, while this case report represents a rare scenario in clinical practice and no consensus exists in the literature on this topic, a psychiatric screening for suicide risk in patients using of CQ and HCQ could be carefully considered.

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“…Individuals with a history of high-lethality suicide attempts had a higher number of neutrophils, mean platelet volume, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio, as well as a lower number of lymphocytes relative to both those with low-lethality suicide attempts and the control group. 5 The same research group previously observed that lower total cholesterol and higher c-reactive protein serum levels were associated with high-lethality suicide attempts. 6 We compared high and low-lethality drug-free depressed suicide attempters with comorbid alcoholism.…”

mentioning

confidence: 91%

The pathophysiology of high-lethality suicide attempts: a vital area of suicide research

Sher

2022

Braz. J. Psychiatry

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High-lethality of suicide attempts associated with platelet to lymphocyte ratio and mean platelet volume in psychiatric inpatient setting

Cited by 22 publications

References 38 publications

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

Chloroquine/Hydroxychloroquine Use and Suicide Risk: Hypotheses for Confluent Etiopathogenetic Mechanisms?

The pathophysiology of high-lethality suicide attempts: a vital area of suicide research

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