Hostname: page-component-cb9f654ff-rkzlw Total loading time: 0 Render date: 2025-08-02T16:26:40.363Z Has data issue: false hasContentIssue false
  • English
  • Français

Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation

Published online by Cambridge University Press:  23 April 2020

Emily A. Dolsen Open the ORCID record for Emily A. Dolsen [Opens in a new window] ,
Aric A. Prather ,
Femke Lamers  and
Brenda W. J. H. Penninx
Emily A. Dolsen*
Affiliation:
Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA94720, USA
Aric A. Prather
Affiliation:
Department of Psychiatry, University of California San Francisco, San Francisco, CA94118, USA
Femke Lamers
Affiliation:
Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
Brenda W. J. H. Penninx
Affiliation:
Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
*
Author for correspondence: Emily A. Dolsen, E-mail: emily.dolsen@ucsf.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA).

Methods

Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained.

Results

Short sleep duration (⩽6 h) compared to normal sleep duration (7–9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13–2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02–4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14–1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02–1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00–1.05).

Conclusions

These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.

Keywords

Anxietydepressioninflammationinsomniasleepsuicide

Information

Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 12 , September 2021 , pp. 2094 - 2103
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

*

Article last updated 18 January 2022.

References

Arai, K., Lee, F., Miyajima, A., Miyatake, S., Arai, N., & Yokota, T. (1990). Cytokines: Coordinators of immune and inflammatory responses. Annual Review of Biochemistry, 59(1), 783–836.CrossRefGoogle ScholarPubMed
Batty, G. D., Bell, S., Stamatakis, E., & Kivimäki, M. (2016). Association of systemic inflammation with risk of completed suicide in the general population. JAMA Psychiatry, 73(9), 993–995. https://doi.org/10.1001/jamapsychiatry.2016.1805.CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893.CrossRefGoogle ScholarPubMed
Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The Scale for Suicide Ideation. Journal of Consulting and Clinical Psychology, 47(2), 343–352. https://doi.org/10.1037/0022-006X.47.2.343.CrossRefGoogle ScholarPubMed
Bernert, R. A., & Joiner, T. E. (2007). Sleep disturbances and suicide risk: A review of the literature. Neuropsychiatric Disease and Treatment, 3(6), 735–743. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2656315&tool=pmcentrez&rendertype=abstract.CrossRefGoogle ScholarPubMed
Bernert, R. A., & Nadorff, M. R. (2015). Sleep disturbances and suicide risk. Sleep Medicine Clinics, 10(1), 35–39. https://doi.org/10.1016/j.jsmc.2014.11.004.CrossRefGoogle ScholarPubMed
Black, C., & Miller, B. J. (2015). Meta-analysis of cytokines and chemokines in suicidality: Distinguishing suicidal versus nonsuicidal patients. Biological Psychiatry, 78(1), 28–37. https://doi.org/10.1016/j.biopsych.2014.10.014.CrossRefGoogle ScholarPubMed
Brebner, K., Hayley, S., Zacharko, R., Merali, Z., & Anisman, H. (2000). Synergistic effects of interleukin-1β, interleukin-6, and tumor necrosis factor-α: Central monoamine, corticosterone, and behavioral variations. Neuropsychopharmacology, 22(6), 566–580. https://doi.org/10.1016/S0893-133X(99)00166-9.CrossRefGoogle ScholarPubMed
Brower, K. J., McCammon, R. J., Wojnar, M., Ilgen, M. A., Wojnar, J., & Valenstein, M. (2011). Prescription sleeping pills, insomnia, and suicidality in the national comorbidity survey replication. Journal of Clinical Psychiatry, 72(4), 515–521. https://doi.org/10.4088/JCP.09m05484gry.CrossRefGoogle ScholarPubMed
Brundin, L., Bryleva, E. Y., & Thirtamara Rajamani, K. (2017). Role of inflammation in suicide: From mechanisms to treatment. Neuropsychopharmacology, 42(1), 271–283. https://doi.org/10.1038/npp.2016.116.CrossRefGoogle Scholar
Bryant, P. A., Trinder, J., & Curtis, N. (2004). Sick and tired: Does sleep have a vital role in the immune system? Nature Reviews Immunology, 4(6), 457–467. https://doi.org/10.1038/nri1369.CrossRefGoogle ScholarPubMed
Burgos, I., Richter, L., Klein, T., Fiebich, B., Feige, B., Lieb, K., … Riemann, D. (2006). Increased nocturnal interleukin-6 excretion in patients with primary insomnia: A pilot study. Brain, Behavior, and Immunity, 20(3), 246–253. https://doi.org/10.1016/j.bbi.2005.06.007.CrossRefGoogle ScholarPubMed
Chakravorty, S., Siu, H. Y. K., Lalley-Chareczko, L., Brown, G. K., Findley, J. C., Perlis, M. L., & Grandner, M. A. (2015). Sleep duration and insomnia symptoms as risk factors for suicidal ideation in a nationally representative sample. The Primary Care Companion For CNS Disorders, 17(6). https://doi.org/10.4088/PCC.13m01551.Google Scholar
Dantzer, R., O'Connor, J. C., Freund, G. G., Johnson, R. W., & Kelley, K. W. (2008). From inflammation to sickness and depression: When the immune system subjugates the brain. Nature Reviews. Neuroscience, 9(1), 46–56. https://doi.org/10.1038/nrn2297.CrossRefGoogle ScholarPubMed
DellaGioia, N., & Hannestad, J. (2010). A critical review of human endotoxin administration as an experimental paradigm of depression. Neuroscience and Biobehavioral Reviews, 34, 130–143. https://doi.org/10.1016/j.neubiorev.2009.07.014.CrossRefGoogle ScholarPubMed
Dowd, J. B., Goldman, N., & Weinstein, M. (2011). Sleep duration, sleep quality, and biomarkers of inflammation in a Taiwanese population. Annals of Epidemiology, 21(11), 799–806. https://doi.org/10.1016/j.annepidem.2011.07.004.CrossRefGoogle Scholar
Ducasse, D., Olié, E., Guillaume, S., Artéro, S., & Courtet, P. (2015). A meta-analysis of cytokines in suicidal behavior. Brain, Behavior, and Immunity, 46, 203–211. https://doi.org/10.1016/j.bbi.2015.02.004.CrossRefGoogle ScholarPubMed
Eikelenboom, M., Beekman, A. T. F., Penninx, B. W. J. H., & Smit, J. H. (2018). A 6-year longitudinal study of predictors for suicide attempts in major depressive disorder. Psychological Medicine, 49(6), 1–11. https://doi.org/10.1017/S0033291718001423.Google ScholarPubMed
Fuster, J. J., & Walsh, K. (2014). The good, the bad, and the ugly of interleukin-6 signaling. The EMBO Journal, 33(13), 1425–1427. https://doi.org/10.15252/embj.201488856.CrossRefGoogle ScholarPubMed
Gabay, C. (2006). Interleukin-6 and chronic inflammation. Arthritis Research and Therapy, 8(Suppl. 2), S3. https://doi.org/10.1186/ar1917.CrossRefGoogle ScholarPubMed
Ganança, L., Oquendo, M. A., Tyrka, A. R., Cisneros-Trujillo, S., Mann, J. J., & Sublette, M. E. (2016). The role of cytokines in the pathophysiology of suicidal behavior. Psychoneuroendocrinology, 63, 296–310. https://doi.org/10.1016/j.psyneuen.2015.10.008.CrossRefGoogle ScholarPubMed
Gerrits, M. M., van Oppen, P., van Marwijk, H. W., van der Horst, H., & Penninx, B. W. (2012). The impact of chronic somatic diseases on the course of depressive and anxiety disorders. Psychotherapy and Psychosomatics, 82(1), 64–66. https://doi.org/10.1159/000338636.CrossRefGoogle ScholarPubMed
Goodwin, R. D., & Marusic, A. (2008). Association between short sleep and suicidal ideation and suicide attempt among adults in the general population. Sleep, 31(8), 1097–1101. https://doi.org/10.1027/0227-5910/a000104.Google ScholarPubMed
Grandner, M. A., & Drummond, S. P. A. (2007). Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Medicine Reviews, 11(5), 341–360. https://doi.org/10.1016/j.smrv.2007.03.010.CrossRefGoogle Scholar
Guo, L., Xu, Y., Deng, J., Huang, J., Huang, G., Gao, X., … Lu, C. (2017). Association between sleep duration, suicidal ideation, and suicidal attempts among Chinese adolescents: The moderating role of depressive symptoms. Journal of Affective Disorders, 208, 355–362. https://doi.org/10.1016/j.jad.2016.10.004.CrossRefGoogle ScholarPubMed
Hall, M. H., Smagula, S. F., Boudreau, R. M., Ayonayon, H. N., Goldman, S. E., Harris, T. B., … Newman, A. B. (2015). Association between sleep duration and mortality is mediated by markers of inflammation and health in older adults: The Health, Aging and Body Composition Study. Sleep, 38(2), 189–195. https://doi.org/10.5665/sleep.4394.CrossRefGoogle Scholar
Han, J., Chen, D., Liu, D., & Zhu, Y. (2018). Modafinil attenuates inflammation via inhibiting Akt/NF-κB pathway in apoE-deficient mouse model of atherosclerosis. Inflammopharmacology, 26(2), 385–393. https://doi.org/10.1007/s10787-017-0387-3.CrossRefGoogle ScholarPubMed
Irwin, M. R. (2015). Why sleep is important for health: A psychoneuroimmunology perspective. Annual Review of Psychology, 66, 143–172. https://doi.org/10.1146/annurev-psych-010213-115205.CrossRefGoogle ScholarPubMed
Irwin, M. R., & Miller, A. H. (2007). Depressive disorders and immunity: 20 years of progress and discovery. Brain, Behavior, and Immunity, 21(4), 374–383. https://doi.org/10.1016/j.bbi.2007.01.010.CrossRefGoogle ScholarPubMed
Irwin, M. R., Olmstead, R., Breen, E. C., Witarama, T., Carrillo, C., Sadeghi, N., … Cole, S. (2015a). Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: A randomized controlled trial. Biological Psychiatry, 78(10), 721–729. https://doi.org/10.1016/j.biopsych.2015.01.010.CrossRefGoogle Scholar
Irwin, M. R., Olmstead, R., & Carroll, J. E. (2015b). Sleep disturbance, sleep duration, and inflammation: A systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biological Psychiatry, 80(1), 40–52. https://doi.org/10.1016/j.biopsych.2015.05.014.CrossRefGoogle Scholar
Janelidze, S., Mattei, D., Westrin, Å, Träskman-Bendz, L., & Brundin, L. (2011). Cytokine levels in the blood may distinguish suicide attempters from depressed patients. Brain, Behavior, and Immunity, 25(2), 335–339. https://doi.org/10.1016/j.bbi.2010.10.010.CrossRefGoogle ScholarPubMed
Jike, M., Itani, O., Watanabe, N., Buysse, D. J., & Kaneita, Y. (2018). Long sleep duration and health outcomes: A systematic review, meta-analysis and meta-regression. Sleep Medicine Reviews, 39, 25–36. https://doi.org/10.1016/J.SMRV.2017.06.011.CrossRefGoogle Scholar
Kim, J.-H., Park, E.-C., Cho, W.-H., Park, C. Y., Park, J.-Y., Choi, W.-J., & Chang, H.-S. (2013). Association between total sleep duration and suicidal ideation among the Korean general adult population. Sleep, 36(10), 1563–1572. https://doi.org/10.5665/sleep.3058.CrossRefGoogle ScholarPubMed
Köhler-Forsberg, O., Lydholm, N. C., Hjorthøj, C., Nordentoft, M., Mors, O., & Benros, M. E. (2019). Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: Meta-analysis of clinical trials. Acta Psychiatrica Scandinavica, 139, 404–419. https://doi.org/10.1111/acps.13016.CrossRefGoogle ScholarPubMed
Levine, D. W., Kaplan, R. M., Kripke, D. F., Bowen, D. J., Naughton, M. J., & Shumaker, S. A. (2003a). Factor structure and measurement invariance of the Women's Health Initiative Insomnia Rating Scale. Psychological Assessment, 15(2), 123–136. https://doi.org/10.1037/1040-3590.15.2.123.CrossRefGoogle Scholar
Levine, D. W., Lewis, M. A., Bowen, D. J., Kripke, D. F., Kaplan, R. M., Naughton, M. J., & Shumaker, S. A. (2003b). Reliability and validity of Women's Health Initiative Insomnia Rating Scale. Psychological Assessment, 15(2), 137–148. https://doi.org/10.1037/1040-3590.15.2.137.CrossRefGoogle Scholar
Li, S. X., Lam, S. P., Yu, M. W. M., Zhang, J., & Wing, Y. K. (2010). Nocturnal sleep disturbances as a predictor of suicide attempts among psychiatric outpatients. The Journal of Clinical Psychiatry, 71(11), 1440–1446. https://doi.org/10.4088/JCP.09m05661gry.CrossRefGoogle ScholarPubMed
Liu, J.-W., Tu, Y.-K., Lai, Y.-F., Lee, H.-C., Tsai, P.-S., Chen, T.-J., … Chiu, H.-Y. (2019). Associations between sleep disturbances and suicidal ideation, plans, and attempts in adolescents: A systematic review and meta-analysis. Sleep, 42(6), 119–126. https://doi.org/10.1093/sleep/zsz054.CrossRefGoogle ScholarPubMed
May, A. M., & Klonsky, E. D. (2016). What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors. Clinical Psychology: Science and Practice, 23(1), 5–20. https://doi.org/10.1111/cpsp.12136.Google Scholar
McCall, W. V., Benca, R. M., Rosenquist, P. B., Youssef, N. A., McCloud, L., Newman, J. C., … Krystal, A. D. (2019). Reducing suicidal ideation through insomnia treatment (REST-IT): A randomized clinical trial. American Journal of Psychiatry, 176(11), 957–965. https://doi.org/10.1176/appi.ajp.2019.19030267.CrossRefGoogle ScholarPubMed
Michaels, M. S., Balthrop, T., Nadorff, M. R., & Joiner, T. E. (2017). Total sleep time as a predictor of suicidal behaviour. Journal of Sleep Research, 26(6), 732–738. https://doi.org/10.1111/jsr.12563.CrossRefGoogle ScholarPubMed
Miller, M. A., Kandala, N.-B., Kivimaki, M., Kumari, M., Brunner, E. J., Lowe, G. D. O., … Cappuccio, F. P. (2009). Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep, 32(7), 857–864. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19639748.Google Scholar
Motivala, S. J., Sarfatti, A., Olmos, L., & Irwin, M. R. (2005). Inflammatory markers and sleep disturbance in major depression. Psychosomatic Medicine, 67(2), 187–194. https://doi.org/10.1097/01.psy.0000149259.72488.09.CrossRefGoogle ScholarPubMed
Mullington, J. M., Simpson, N. S., Meier-Ewert, H. K., & Haack, M. (2010). Sleep loss and inflammation. Best Practice & Research Clinical Endocrinology & Metabolism, 24(5), 775–784. https://doi.org/10.1016/j.beem.2010.08.014.CrossRefGoogle ScholarPubMed
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., … Williams, D. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192(2), 98–105. https://doi.org/10.1192/bjp.bp.107.040113.CrossRefGoogle Scholar
Okun, M. L., Reynolds, C. F., Buysse, D. J., Monk, T. H., Mazumdar, S., Begley, A., & Hall, M. H. (2011). Sleep variability, health-related practices, and inflammatory markers in a community dwelling sample of older adults. Psychosomatic Medicine, 73(2), 142–150. https://doi.org/10.1097/PSY.0b013e3182020d08.CrossRefGoogle Scholar
Patel, S. R., Zhu, X., Storfer-Isser, A., Mehra, R., Jenny, N. S., Tracy, R., & Redline, S. (2009). Sleep duration and biomarkers of inflammation. Sleep, 32(2), 200–204. https://doi.org/10.1093/sleep/32.2.200.CrossRefGoogle ScholarPubMed
Pearson, T. A., Mensah, G. A., Alexander, R. W., Anderson, J. L., Cannon, R. O., Criqui, M., … Vinicor, F. (2003). Markers of inflammation and cardiovascular disease. Circulation, 107(3), 499–511. https://doi.org/10.1161/01.CIR.0000052939.59093.45.CrossRefGoogle Scholar
Penninx, B. W. J. H., Beekman, A. T. F., Smit, J. H., Zitman, F. G., Nolen, W. A., & Spinhoven, P., … NESDA Research Consortium. (2008). The Netherlands Study of Depression and Anxiety (NESDA): Rationale, objectives and methods. International Journal of Methods in Psychiatric Research, 17(3), 121–140. https://doi.org/10.1002/mpr.256.CrossRefGoogle ScholarPubMed
Perlis, M. L., Grandner, M. A., Chakravorty, S., Bernert, R. A., Brown, G. K., & Thase, M. E. (2015). Suicide and sleep: Is it a bad thing to be awake when reason sleeps? Sleep Medicine Reviews, 29, 101–107. https://doi.org/10.1016/j.smrv.2015.10.003.CrossRefGoogle ScholarPubMed
Pompili, M., Innamorati, M., Forte, A., Longo, L., Mazzetta, C., Erbuto, D., … Girardi, P. (2013). Insomnia as a predictor of high-lethality suicide attempts. International Journal of Clinical Practice, 67(12), 1311–1316. https://doi.org/10.1111/ijcp.12211.CrossRefGoogle ScholarPubMed
Prather, A. A., Rabinovitz, M., Pollock, B. G., & Lotrich, F. E. (2009). Cytokine-induced depression during IFN-α Treatment: The role of IL-6 and sleep quality. Brain, Behavior, and Immunity, 23(8), 1109–1116. https://doi.org/10.1016/j.bbi.2009.07.001.CrossRefGoogle ScholarPubMed
Prather, A. A., Vogelzangs, N., & Penninx, B. W. J. H. (2015). Sleep duration, insomnia, and markers of systemic inflammation: Results from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Psychiatric Research, 60, 95–102. https://doi.org/10.1016/j.jpsychires.2014.09.018.CrossRefGoogle Scholar
Raison, C. L., Capuron, L., & Miller, A. H. (2006). Cytokines sing the blues: Inflammation and the pathogenesis of depression. Trends in Immunology, 27(1), 24–31. https://doi.org/10.1016/j.it.2005.11.006.CrossRefGoogle ScholarPubMed
R Development Core Team. (2018). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vol. 1. https://doi.org/10.1007/978-3-540-74686-7.CrossRefGoogle Scholar
Rijnhart, J. J. M., Twisk, J. W. R., Eekhout, I., & Heymans, M. W. (2019). Comparison of logistic-regression based methods for simple mediation analysis with a dichotomous outcome variable. BMC Medical Research Methodology, 19(1), 19. https://doi.org/10.1186/s12874-018-0654-z.CrossRefGoogle ScholarPubMed
Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02.CrossRefGoogle Scholar
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B., & Trivedi, M. H. (1996). The inventory of depressive symptomatology (IDS): Psychometric properties. Psychological Medicine, 26(3), 477. https://doi.org/10.1017/S0033291700035558.CrossRefGoogle ScholarPubMed
Salim, S., Chugh, G., & Asghar, M.. (2012). Inflammation in anxiety. In Donev, Rossen (Ed.), Advances in protein chemistry and structural biology (Vol. 88, pp. 1–25). Oxford: Academic Press.Google Scholar
Scheller, J., Chalaris, A., Schmidt-Arras, D., & Rose-John, S. (2011). The pro- and anti-inflammatory properties of the cytokine interleukin-6. Biochimica et Biophysica Acta – Molecular Cell Research, 1813(5), 878–888. https://doi.org/10.1016/j.bbamcr.2011.01.034.CrossRefGoogle ScholarPubMed
Scrivo, R., Vasile, M., Bartosiewicz, I., & Valesini, G. (2011). Inflammation as ‘common soil’ of the multifactorial diseases. Autoimmunity Reviews, 10, 369–374. https://doi.org/10.1016/j.autrev.2010.12.006.CrossRefGoogle Scholar
Szelényi, J. (2001). Cytokines and the central nervous system. Brain Research Bulletin, 54(4), 329–338. https://doi.org/10.1016/S0361-9230(01)00428-2.CrossRefGoogle ScholarPubMed
Trockel, M., Karlin, B. E., Taylor, C. B., Brown, G. K., & Manber, R. (2015). Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans. Sleep, 38(2), 259–265. https://doi.org/10.5665/sleep.4410.CrossRefGoogle ScholarPubMed
Vgontzas, A. N., Fernandez-Mendoza, J., Liao, D., & Bixler, E. O. (2013). Insomnia with objective short sleep duration: The most biologically severe phenotype of the disorder. Sleep Medicine Reviews, 17, 241–254. https://doi.org/10.1016/j.smrv.2012.09.005.CrossRefGoogle ScholarPubMed
Vogelzangs, N., Beekman, A. T. F., de Jonge, P., & Penninx, B. W. J. H. (2013). Anxiety disorders and inflammation in a large adult cohort. Translational Psychiatry, 3(4), e249. https://doi.org/10.1038/tp.2013.27.CrossRefGoogle Scholar
Wittchen, H. U. (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review. Journal of Psychiatric Research, 28(1), 57–84. https://doi.org/10.1016/0022-3956(94)90036-1.CrossRefGoogle ScholarPubMed
Wium-Andersen, M. K., Ørsted, D. D., Nielsen, S. F., Nordestgaard, B. G., Kim Wium-Andersen, M., Dynnes Ørsted, D., … Grønne Nordestgaard, B. (2013). Elevated C-reactive protein levels, psychological distress, and depression in 73, 131 individuals. JAMA Psychiatry, 70(2), 176–184. https://doi.org/10.1001/2013.jamapsychiatry.102.CrossRefGoogle ScholarPubMed
World Health Organization (2014). Preventing suicide: A global imperative. Geneva: World Health Organization.Google Scholar
Supplementary material: File

Dolsen et al. supplementary material

Table S1

Download Dolsen et al. supplementary material(File)
File 65.5 KB