Lifetime Subthreshold Mania is Related to Suicidality in Posttraumatic Stress Disorder

Abstract

Introduction: Although the association between mood disorders, and particularly bipolar disorders, comorbidity and suicidality in posttraumatic (PTSD) patients is well established, less information is available on the impact of subsyndromal mood symptoms. The aim of the present study was, thus, to explore the frequency and relationship between subthreshold mood symptoms, assessed by a specific and validated questionnaire, and suicidality in PTSD patients.Method: Sixty-five PTSD outpatients without bipolar disorders and 65 healthy control subjects were asked to complete the Mood Spectrum-SR-Lifetime Version (MOODS-SR), a questionnaire exploring the presence of subthreshold affective symptoms. Logistic regression models were used to analyze the relationships between suicidality, explored by six items of the MOODS-SR combined and dichotomized to denote the presence or absence of suicidal ideations/plans and/or attempts, and the number of manic/hypomanic or depressive symptoms.Results: Statistically significant and positive associations were found between the presence of manic/hypomanic and depressive symptoms and the likelihood of suicidal ideation or attempts.Conclusion: Besides depressive, even subthreshold manic/hypomanic features seem to be associated with higher suicidality in PTSD patients.

Complicated Grief and Manic Comorbidity in the Aftermath of the Loss of a Son

“…[36][37][38][39] A significant correlation between lifetime mood spectrum symptoms (assessed by the MOODS-SR, lifetime version) and increased suicidal ideation and/or attempts has previously been demonstrated in patients with complicated grief, 38 similar to that observed in patients with PTSD. [40][41][42] Interestingly, in a previous study, 38 we found significant correlations between complicated grief and subthreshold manic symptoms, ryhtmicity/vegetative function items, and depressive symptoms on the MOODS-SR. These relationships remained significant after controlling for comorbid Axis I disorders.…”

Complicated Grief and Suicidality: The Impact of Subthreshold Mood Symptoms

“…This may be considered in agreement with the available information reporting a link between subthreshold manic symptoms and suicidality in both the general population and in other psychiatric disorders. 23,25,[43][44][45][46][47] It is noteworthy that also the rhythmicity and vegetative function symptoms were related to increased suicidality. Although this matter is controversial, it can be concluded that some patients with different diagnoses may be more sensitive to weather-and/or season-related changes [48][49][50] and, as such, more prone to suicide.…”

“…22 Generally, the bipolar comorbidity, either the full-blown disorder or the subthreshold symptoms, is considered to enhance the vulnerability towards suicide in patients with different psychiatric disorders. [23][24][25][26] Since no information is available regarding CG, the aim of the present study was to explore the possible relationship between subthreshold mood spectrum symptoms and suicidality in patients with CG.…”

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

“…A consecutive sample of 65 out- and inpatients of both sexes (33 men and 32 women, mean age ± SD: 45 ± 14.8 years), with a DSM-IV-TR diagnosis of chronic PTSD, was recruited at the Section of Psychiatry of the Department of Clinical and Experimental Medicine, University of Pisa, Italy. Methods and sample characteristics were described in details in a previous study [ 38 ]. The majority of patients were married or living with a partner (N = 37, 56.9%), and had more than 8 years of education (N = 38, 58.4%).…”