Hypoxia-related risk factors for death by suicide in a national clinical sample

Riblet, Natalie; Gottlieb, Daniel J.; Watts, Bradley V.; Cornelius, Sarah; Fan, Vincent S.; Shi, Xun; Shiner, Brian

doi:10.1016/j.psychres.2019.01.040

Cited by 22 publications

(34 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Suicide is linearly related to living at a high altitude (OR increase 1.2/1000 m of altitude) 91,92 . Exposure to hypoxia, from altitude, smoking, or ENDS, was associated with increased suicides in 9,620,944 people with 22,403 suicides 91 . ENDS have a similar or greater risk relative to conventional cigarettes, causing high levels of intermittent hypoxic stress even without nicotine 93 .…”

Section: Results: Epidemiology and Pharmacologymentioning

confidence: 99%

See 1 more Smart Citation

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

et al. 2021

View full text Add to dashboard Cite

Background and Objectives Extensive evidence links smoking and suicide independently of psychiatric diagnoses, but there are questions about the pathophysiology and specificity of this relationship. We examined characteristics of this linkage to identify potential transdiagnostic mechanisms in suicide and its prevention. Methods We reviewed literature that associated suicide with smoking and e‐cigarettes, including the temporal sequence of smoking and suicide risk and their shared behavioral risk factors of sensitization and impulsivity. Results Smoking is associated with increased suicide across psychiatric diagnoses and in the general population, proportionately to the number of cigarettes smoked per day. Rapid nicotine uptake into the brain through inhalation of conventional cigarettes, electronic cigarettes (e‐cigarette), or even second‐hand smoke can facilitate long‐term sensitization and short‐term impulsivity. Both impair action regulation and predispose to negative affect, continued smoking, and suicidal behavior. Intermittent hypoxia, induced by cigarettes or e‐cigarettes, synergistically promotes impulsivity and sensitization, exacerbating suicidality. Two other shared behavioral risks also develop negative urgency (combined impulsivity and negative affect) and cross‐sensitization to stressors or to other addictive stimuli. Finally, early smoking onset, promoted by e‐cigarettes in never‐smokers, increases subsequent suicide risk. Conclusion and Scientific Significance Prevention or cessation of nicotine inhalation can strategically prevent suicidality and other potentially lethal behavior regardless of psychiatric diagnoses. Medications for reducing smoking and suicidality, especially in younger smokers, should consider the neurobehavioral mechanisms for acute impulsivity and longer‐term sensitization, potentially modulated more effectively through glutamate antagonism rather than nicotine substitution. (Am J Addict 2021;30:316–329)

show abstract

Section: Results: Epidemiology and Pharmacologymentioning

confidence: 99%

Section: Results: Epidemiology and Pharmacologymentioning

confidence: 99%

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

et al. 2021

View full text Add to dashboard Cite

show abstract

“…While our findings are difficult to interpret in isolation, they fit into a model of mitochondrial dysfunction in BD when considered in the context of what is known about hypoxia, suicide, and mood disorders. For example, it has been reported that patients with hypoxic chronic medical conditions are at increased risk for suicide, and that this risk increases with altitude . Pulmonary functions could be compromised paradoxically by elevation of altitude .…”

Section: Discussionmentioning

confidence: 99%

“…For example, it has been reported that patients with hypoxic chronic medical conditions are at increased risk for suicide, and that this risk increases with altitude. 73 Pulmonary functions could be compromised paradoxically by elevation of altitude. [74][75][76] In addition, patients with BD demonstrate reduced cerebral blood flow to critical brain structures, 77 which may further reduce oxygen delivery, adding to hypoxic stress in BD at increased altitude.…”

Section: Discussionmentioning

confidence: 99%

Cerebral bioenergetic differences measured by phosphorus‐31 magnetic resonance spectroscopy between bipolar disorder and healthy subjects living in two different regions suggesting possible effects of altitude

Hwang

DeLisi

Öngür

et al. 2019

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

Aim Increased oxidative stress in cerebral mitochondria may follow exposure to the systemic hypobaric hypoxia associated with residing at higher altitudes. Because mitochondrial dysfunction is implicated in bipolar disorder (BD) pathophysiology, this may impact the cerebral bioenergetics in BD. In this study, we evaluated the cerebral bioenergetics of BD and healthy control (HC) subjects at two sites, located at sea level and at moderate altitude. Methods Forty‐three veterans with BD and 33 HC veterans were recruited in Boston (n = 22) and Salt Lake City (SLC; n = 54). Levels of phosphocreatine, β nucleoside triphosphate (βNTP), inorganic phosphate, and pH over total phosphate (TP) were measured using phosphorus‐31 magnetic resonance spectroscopy in the following brain regions: anterior cingulate cortex and posterior occipital cortex, as well as bilateral prefrontal and occipitoparietal (OP) white matter (WM). Results A significant main effect of site was found in βNTP/TP (Boston > SLC) and phosphocreatine/TP (Boston < SLC) in most cortical and WM regions, and inorganic phosphate/TP (Boston < SLC) in OP regions. A main effect analysis of BD diagnosis demonstrated a lower pH in posterior occipital cortex and right OP WM and a lower βNTP/TP in right prefrontal WM in BD subjects, compared to HC subjects. Conclusion The study showed that there were cerebral bioenergetic differences in both BD and HC veteran participants at two different sites, which may be partly explained by altitude difference. Future studies are needed to replicate these results in order to elucidate the dysfunctional mitochondrial changes that occur in response to hypobaric hypoxia.

show abstract

“…There is also extensive, and growing, evidence accumulated by our group and others that increased altitude of residence, which may be associated with chronic relative hypoxia, is a risk factor for depression, suicide, and related adverse psychiatric outcomes [74,75,76,77,78,79,80,81,82,83,84,85,86,87,88]. In conjunction with this, it has been show that simulated high altitude can produce depression in a rodent model, and that these symptoms are not responsive to most antidepressants [89,90,91,92].…”

Section: Methodsmentioning

confidence: 99%

Creatine for the Treatment of Depression

2019

View full text Add to dashboard Cite

Depressed mood, which can occur in the context of major depressive disorder, bipolar disorder, and other conditions, represents a serious threat to public health and wellness. Conventional treatments are not effective for a significant proportion of patients and interventions that are often beneficial for treatment-refractory depression are not widely available. There is, therefore, an immense need to identify novel antidepressant strategies, particularly strategies that target physiological pathways that are distinct from those addressed by conventional treatments. There is growing evidence from human neuroimaging, genetics, epidemiology, and animal studies that disruptions in brain energy production, storage, and utilization are implicated in the development and maintenance of depression. Creatine, a widely available nutritional supplement, has the potential to improve these disruptions in some patients, and early clinical trials indicate that it may have efficacy as an antidepressant agent.

show abstract

Hypoxia-related risk factors for death by suicide in a national clinical sample

Cited by 22 publications

References 28 publications

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms

Cerebral bioenergetic differences measured by phosphorus‐31 magnetic resonance spectroscopy between bipolar disorder and healthy subjects living in two different regions suggesting possible effects of altitude

Creatine for the Treatment of Depression

Contact Info

Product

Resources

About