Suicidal risk and demoralization in Parkinson disease

Elfil, Mohamed; Ahmed, Nada; Alapati, Amritha; Bahekar, Rucha; Kandil, Mohamed; Kim, Christine; Schaefer, Sara M.; Tinaz, Sule; Patel, Amar; Figueiredo, John M. de; Louis, Elan D.; Koo, Brian B.

doi:10.1007/s00415-019-09632-2

Cited by 24 publications

(25 citation statements)

References 36 publications

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“…However, Nanni et al found that of the patients with suicidal ideation, 25% are demoralized but not clinically depressed 21 . Previous studies have proved that demoralization has a more significant influence than depression on suicidal ideation 18,22,23 …”

Section: Introductionmentioning

confidence: 99%

“…21 Previous studies have proved that demoralization has a more significant influence than depression on suicidal ideation. 18,22,23 The relationships among hopelessness, depression, suicidal ideation and demoralization are complex and not well understood. Some studies have linked hopelessness and depression to suicidal ideation, 9,16 while other studies have linked depression and demoralization to suicidal ideation.…”

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confidence: 99%

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Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation

Liu

Wang

et al. 2020

Psycho-Oncology

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Objective: Suicidal ideation is common in cancer patients and may be associated with hopelessness, demoralization, and depression. This study aims to investigate the serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation in cancer patients. Methods: A total of 244 cancer patients were investigated by using the following standardized self-reported questionnaires: self-rating idea of suicide scale, Beck hopelessness scale, demoralization scale-Mandarin version, and patient health questionnaire depression scale-9. The mediation hypothesis was tested with a serial multiple mediation model (PROCESS model 6). An exploratory graph analysis was performed to detect the correlations among the dimensions of the mental conditions measured by these instruments. Results: Bootstrap analyzes indicate that there were direct and indirect effects of hopelessness on suicidal ideation mediated solely by demoralization (B = 2.3074, SE = 0.1724, P < .001) or by demoralization together with depression (B = 0.1605, SE = 0.0303, 95% confidence interval [CI] = 0.1102 to 0.2303). The mediation of depression alone in the relationship between hopelessness and suicidal ideation was insignificant (B = 0.1541, SE = 0.0519, 95% CI = −0.0565 to 0.0715). The exploratory graph analysis suggests that the strongest edge of dimensions between demoralization and suicidal ideation was desperation-disheartenment (0.62). Conclusions: The results of the study support the hypothesis that demoralization and depression mediate between hopelessness and suicidal ideation. The early identification of and interventions for hopelessness, demoralization, and depression may prevent cancer patients from developing suicidal ideation.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation

Liu

Wang

et al. 2020

Psycho-Oncology

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“…The majority of the studies have suggested that demoralization is distinguishable from depression [84,85,92]. However, in patients with cancer [94][95][96][97][98][99][100], Parkinson's disease [101], as well as other psychiatric and medical conditions [89,[102][103][104][105], there may be frequent overlaps between demoralization and depression. Nevertheless, demoralization can occur independently of depression and the two conditions are not necessarily linked by a hierarchical connection [89,99,105,106].…”

Section: Psychiatric and Psychosocial Hypotheses For Suicidality Etiomentioning

confidence: 99%

Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms

Costanza

Radomska

Zenga

et al. 2021

IJERPH

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Chronic traumatic encephalopathy (CTE) results from repetitive brain injuries and is a common neurotraumatic sequela in contact sports. CTE is often accompanied by neuropsychiatric symptoms, which could escalate to suicidal ideation (SI) and suicidal behaviour (SB). Nevertheless, fairly limited emphasis about the association between suicidality and CTE exists in medical literature. Here, we report two cases of retired professional athletes in high contact sports (boxing and ice hockey) who have developed similar clinical trajectories characterized by progressive neuropsychiatric symptoms compatible with a CTE diagnosis and subsequent SB in its severe forms (medical serious suicide attempt (SA) and completed suicide). In addition to the description of outlining clinical, neuropsychological, neuroimaging, and differential diagnosis elements related to these cases, we also hypothesized some mechanisms that might augment the suicide risk in CTE. They include those related to neurobiological (neuroanatomic/neuroinflammatory) dysfunctions as well as those pertaining to psychiatry and psychosocial maladaptation to neurotraumas and retirement from professional competitive activity. Findings described here can provide clinical pictures to improve the identification of patients with CTE and also potential mechanistic insights to refine the knowledge of eventual severe SB development, which might enable its earlier prevention.

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“…Most studies reported SI rates in individuals with PD to be around 30% 19 . Subsequently published studies reported SI present in 31% of individuals with PD in an Italian clinic (higher than age‐ and sex‐matched controls without a neurological disorder [2%]) 21 and 23% of individuals with PD through US‐based recruitment (lower than matched controls [35%]) 22 . Two 2019 systematic reviews regarding suicide in PD reported that multiple studies found a higher risk of suicide in populations with PD compared to controls, but some studies identified no difference between groups 19,20 .…”

Section: Suicide Prevalence In Lbd Pd and Dementiamentioning

confidence: 99%

Suicide and Lewy body dementia: Report of a Lewy body dementia association working group

Armstrong

Sullivan

Amodeo

et al. 2020

Int J Geriat Psychiatry

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Suicidal risk and demoralization in Parkinson disease

Cited by 24 publications

References 36 publications

Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation

Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation

Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms

Suicide and Lewy body dementia: Report of a Lewy body dementia association working group

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