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Risk factors for suicide reattempt: a systematic review and meta-analysis
- Andres Pemau, Carolina Marin-Martin, Marina Diaz-Marsa, Alejandro de la Torre-Luque, Wala Ayad-Ahmed, Ana Gonzalez-Pinto, Nathalia Garrido-Torres, Lucia Garrido-Sanchez, Natalia Roberto, Purificación Lopez-Peña, Lorea Mar-Barrutia, Iria Grande, Marti Guinovart, Daniel Hernandez-Calle, Luis Jimenez-Treviño, Clara Lopez-Sola, Roberto Mediavilla, Adrian Perez-Aranda, Miguel Ruiz-Veguilla, Elisa Seijo-Zazo, Alba Toll, Matilde Elices, Victor Perez-Sola, Jose Luis Ayuso-Mateos, the SURVIVE Consortium
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 16 April 2024, pp. 1-8
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Background
Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor.
MethodsThis systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury).
ResultsThe initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt.
ConclusionMost of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
Link between cognitive polygenic risk scores and clinical progression after a first-psychotic episode
- Alex G. Segura, Gisela Mezquida, Albert Martínez-Pinteño, Patricia Gassó, Natalia Rodriguez, Lucía Moreno-Izco, Silvia Amoretti, Miquel Bioque, Antonio Lobo, Ana González-Pinto, Alicia García-Alcon, Alexandra Roldán-Bejarano, Eduard Vieta, Elena de la Serna, Alba Toll, Manuel J. Cuesta, Sergi Mas, Miquel Bernardo, PEPs Group
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- Journal:
- Psychological Medicine / Volume 53 / Issue 10 / July 2023
- Published online by Cambridge University Press:
- 09 June 2022, pp. 4634-4647
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- Article
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- Open access
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Background
Clinical intervention in early stages of psychotic disorders is crucial for the prevention of severe symptomatology trajectories and poor outcomes. Genetic variability is studied as a promising modulator of prognosis, thus novel approaches considering the polygenic nature of these complex phenotypes are required to unravel the mechanisms underlying the early progression of the disorder.
MethodsThe sample comprised of 233 first-episode psychosis (FEP) subjects with clinical and cognitive data assessed periodically for a 2-year period and 150 matched controls. Polygenic risk scores (PRSs) for schizophrenia, bipolar disorder, depression, education attainment and cognitive performance were used to assess the genetic risk of FEP and to characterize their association with premorbid, baseline and progression of clinical and cognitive status.
ResultsSchizophrenia, bipolar disorder and cognitive performance PRSs were associated with an increased risk of FEP [false discovery rate (FDR) ⩽ 0.027]. In FEP patients, increased cognitive PRSs were found for FEP patients with more cognitive reserve (FDR ⩽ 0.037). PRSs reflecting a genetic liability for improved cognition were associated with a better course of symptoms, functionality and working memory (FDR ⩽ 0.039). Moreover, the PRS of depression was associated with a worse trajectory of the executive function and the general cognitive status (FDR ⩽ 0.001).
ConclusionsOur study provides novel evidence of the polygenic bases of psychosis and its clinical manifestation in its first stage. The consistent effect of cognitive PRSs on the early clinical progression suggests that the mechanisms underlying the psychotic episode and its severity could be partially independent.