Suicide Attempts in Juvenile Bipolar Versus Major Depressive Disorders: Systematic Review and Meta-Analysis

Crescenzo, Franco De; Serra, Giulia; Maisto, Francesco; Uchida, Mai; Woodworth, Hilary; Casini, Maria Luisa; Baldessarini, Ross J.; Vicari, Stefano

doi:10.1016/j.jaac.2017.07.783

Cited by 46 publications

(27 citation statements)

References 32 publications

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“…The clinical manifestations of depression include sustained pessimism, loss of pleasure and appetite, sleep disorders, and deficits in attention (H Wang et al, 2015). More seriously, patients suffering from major depression experience greater rates of self-harm and suicide attempts, which make the condition a serious burden to individuals, their families, and the community (De Crescenzo et al, 2017). Despite ongoing research, the treatment of depression is still a tough problem to solve because of its unknown etiology and pathogenesis, and the current state of antidepressants is still not entirely adequate for widespread success in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of Phosphodiesterase 4 by FCPR03 Alleviates Chronic Unpredictable Mild Stress-Induced Depressive-Like Behaviors and Prevents Dendritic Spine Loss in Mice Hippocampi

Zhong

Niu

et al. 2018

International Journal of Neuropsychopharmacology

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BackgroundPhosphodiesterase 4 is a promising target for developing novel antidepressants. However, prototype phosphodiesterase 4 inhibitors show severe side effects, including nausea and vomiting. N-Isopropyl-3-(cyclopropylmethoxy)-4-difluoromethoxy benzamide (FCPR03) is a novel phosphodiesterase 4 inhibitor with little emetic potential. In the present study, we investigated the inhibitory effect of FCPR03 on chronic unpredictable mild stress-induced, depressive-like behaviors in mice and explored the underlying mechanisms.MethodsThe depression model of mice was established by chronic unpredictable mild stress. Forced swim test, tail suspension test, and sucrose preference test were used to assess depressive-like behaviors. Golgi-staining was utilized to analyze dendritic morphology and spine density. The level of cAMP was measured by enzyme-linked immnosorbent assay assay. Western blot was used to evaluate protein levels of phosphorylated cAMP-response element binding protein, protein kinase B, glycogen synthase kinase-3β, and brain derived neurotrophic factor in both hippocampus and prefrontal cortex. Postsynaptic density protein 95 and synapsin 1 were also detected by western blot in the hippocampi.ResultsTreatment with FCPR03 (0.5–1.0 mg/kg, i.p.) increased consumption of sucrose in the sucrose preference test in mice exposed to chronic unpredictable mild stress. FCPR03 shortened the immobility time in forced swim test and tail suspension test without affecting locomotor activity. Furthermore, chronic unpredictable mild stress decreased the dendritic spine density and dendritic length in the hippocampus. This change was accompanied by decreased expression of postsynaptic density protein 95 and synapsin 1. Interestingly, FCPR03 prevented dendritic spine loss and increased synaptic protein levels. Moreover, the levels of cAMP, phosphorylated cAMP-response element binding protein, and brain derived neurotrophic factor were elevated in chronic unpredictable mild stress-challenged mice after treatment with FCPR03. In addition, FCPR03 also enhanced the phosphorylation of both protein kinase B and glycogen synthase kinase-3β in mice exposed to chronic unpredictable mild stress.ConclusionThe present study suggests that FCPR03 could prevent both depressive-like behaviors and spine loss induced by chronic unpredictable mild stress in the mice hippocampi.

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Section: Introductionmentioning

confidence: 99%

Inhibition of Phosphodiesterase 4 by FCPR03 Alleviates Chronic Unpredictable Mild Stress-Induced Depressive-Like Behaviors and Prevents Dendritic Spine Loss in Mice Hippocampi

Zhong

Niu

et al. 2018

International Journal of Neuropsychopharmacology

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“…Studies have examined whether subjects with mania alone are as impaired as subjects with both mania and depression. De Crescenzo et al found that children and adolescents with both mania and depression were significantly more likely to have a suicide attempt than subjects with mania only, while Merikangas et al found that adolescents with mania only were equally as impaired as adolescents with mania and depression in most areas. However, if the threshold for inclusion into the subthreshold BP group was too low, and participants in the group were not psychiatrically ill, then we would not have expected the subthreshold BP group to differ so significantly from the control group on our outcome measures.…”

Section: Discussionmentioning

confidence: 99%

The morbidity of subthreshold pediatric bipolar disorder: A systematic literature review and meta‐analysis

et al. 2018

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Objective: The objective of this study was to evaluate the morbidity of subthreshold pediatric bipolar (BP) disorder. Methods:We performed a systematic literature search in November 2017 and included studies examining the morbidity of pediatric subthreshold BP. Extracted outcomes included functional impairment, severity of mood symptoms, psychiatric comorbidities, suicidal ideation and behaviors, and mental health treatment. We used meta-analysis to compute the pooled standardized mean difference (SMD) for continuous measures and the pooled risk ratio (RR) for binary measures between two paired groups: subthreshold pediatric BP vs controls and subthreshold pediatric BP vs pediatric BP-I. Results: Eleven papers, consisting of seven datasets, were included. We compared subthreshold pediatric BP (N = 244) to non-BP controls (N = 1125) and subthreshold pediatric BP (N = 643) to pediatric BP-I (N = 942). Subthreshold pediatric BP was associated with greater functional impairment (SMD = 0.61, CI 0.25-0.97), greater severity of mood symptomatology (mania: SMD = 1.88, CI 1.38-2.38; depression: SMD = 0.66, CI 0.52-0.80), higher rates of disruptive behavior (RR = 1.75, CI 1.17-2.62), mood (RR = 1.78, CI 1.29-2.79) and substance use (RR = 2.27, CI 1.23-4.21)disorders, and higher rates of suicidal ideation and attempts (RR = 7.66, CI 1.71-34.33) compared to controls. Pediatric BP-I was associated with greater functional impairment, greater severity of manic symptoms, higher rates of suicidal ideation and attempts, and higher rates of mental health treatment compared to subthreshold pediatric BP. There were no differences between full and subthreshold cases in the severity of depressive symptoms or rates of comorbid disorders.Conclusions: Subthreshold pediatric BP disorder is an identifiable morbid condition associated with significant functional impairment including psychiatric comorbidities and high rates of suicidality. K E Y W O R D Sbipolar disorder, child, pediatric, subthreshold | INTRODUC TI ONAs pediatric bipolar (BP) disorder tends to evolve over time, some youth may present to clinical attention with insufficient symptoms to fulfill full diagnostic criteria for a diagnosis of BP disorder.However, while much is known about full threshold pediatric BP disorder, little is known about subthreshold forms of pediatric BP disorder.

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“…While literature reviews unanimously point to psychosocial risk factors in the occurrence of suicide-related behavior, biological factors, including brain development, should also be mentioned. Research on brain development and connectivity between its parts shows that in adolescents' brains, regions of the amygdala and hippocampus develop earlier than the prefrontal cortex, which is responsible for impulse regulation [3]. This can be observed in frequent mood switches and impulsive behaviors among youth.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Psychosocial Characteristics of Adolescent Pediatric Patients Hospitalized after Different Types of Suicidal Behaviors—A Preliminary Study

Bohaterewicz

Nowicka

Sobczak

et al. 2020

IJERPH

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The objective of this study was to examine the clinical characteristics of adolescents hospitalized after a suicide attempt or instrumental suicide-related behavior. Participants included thirty-six adolescents from the pediatric unit of a Polish hospital who made a nonfatal suicide attempt (SAA) or engaged in instrumental suicide-related behavior (IBA), as well as a general population sample (GPS). Psychosocial features were measured using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Suicide Behaviors Questionnaire–Revised (SBQ-R), the Psychache Scale (TPS), the State–Trait Anxiety Inventory (STAI), the Center of Epidemiological Studies Depression Scale for Children (CES-DC), and the Prodromal Questionnaire (PQ-16). The SAA group scored significantly higher than the IBA group and the GPS in modules related to irritability and anhedonia, voice hallucinations and delusions, suicidal acts, thoughts and ideation, and medical lethality. Additionally, the SAA scored higher on the SBQ-R and PQ-16 compared to the IBA group and the GPS. Although anxiety, mental pain, and depressive symptoms could not independently distinguish between the SAA and IBA groups, psychotic symptoms were more frequently present within the SAA group. The above symptoms may be important to consider when screening for suicide risk in the general population.

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Suicide Attempts in Juvenile Bipolar Versus Major Depressive Disorders: Systematic Review and Meta-Analysis

Cited by 46 publications

References 32 publications

Inhibition of Phosphodiesterase 4 by FCPR03 Alleviates Chronic Unpredictable Mild Stress-Induced Depressive-Like Behaviors and Prevents Dendritic Spine Loss in Mice Hippocampi

Inhibition of Phosphodiesterase 4 by FCPR03 Alleviates Chronic Unpredictable Mild Stress-Induced Depressive-Like Behaviors and Prevents Dendritic Spine Loss in Mice Hippocampi

The morbidity of subthreshold pediatric bipolar disorder: A systematic literature review and meta‐analysis

Clinical and Psychosocial Characteristics of Adolescent Pediatric Patients Hospitalized after Different Types of Suicidal Behaviors—A Preliminary Study

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