The European Journal of Psychiatry

Community study on a parasuicidal population: Clinical identification of repetition risk

Background and Objectives: The greatest predictor of eventual suicide is parasuicide. The aim of this research was to identify the clinical features that can identify people with high parasuicide purpose among a parasuicidal population. Methods: A total of 48 persons who had commited a parasuicide episode 2-6 years after, were interviewed and classified according Research Diagnostic Criteria. During the interviews, socio-demographic data and psychopathological features were picked up through several scales. Scores on Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) and The Plutchick Impulsivity Scale (PI) were measured. These persons were then followed-up for two years. Results: At follow-up, eight persons (16,7%) had repeated at least one parasuicide act. On comparison of repeaters and no repeaters, a higher significant differences in the final values reported in BHS was found but not significative differences were founded in the BAI, BHS or PI scores or in the proportion of the different mental illness (according RDC). An interesting finding is that in the repeaters group the average value in the IP scale tended to be lower than in the non-repeaters, although not significant. A high percentage (72.8%) related the existence of negative vital events with their suicide attempt, more often, relationship problems with the spouse (42.8%), with their parents (17.1%) or the breakdown of an interpersonal relationship (14.2%). Conclusions: In persons who have a past history of previous parasuicides, a high value in BHS is associated with the risk of repetition in the subsequent two years.

Eating habits and attitudes and their relationship with Body Mass Index (BMI)

Background and Objectives: To study the differences in eating attitudes and habits between subjects of normal weight and subjects who are overweight and to analyze in each group the relationship between these habits and attitudes and BMI, taking gender as a modulating variable. Methods: A total of 191 subjects, 117 women and 74 men, took part in this study. 102 subjects made up the overweight/obesity group and 82 subjects made up the control group. All of them were given a questionnaire comprising 26 items (EAT 26 Eating Attitudes Test) plus an additional group of 10 extra items. Results: The overweight group shows a significantly higher score in mood-related ingestion than the group with normal weight. Subsequent analyses indicate that while in the overweight/obesity group there is a positive correlation between the oral control scale and BMI, in the normal weight control group there is a negative correlation between oral control and BMI. Amongst the women in the overweight group a significant relationship was observed between skipping meals, oral control and BMI. 50.7% of the dieters stated that their attempts to lose weight had generally been followed by an even greater weight increase. Furthermore, 88.5% of the dieters stated that they had been unable to maintain the weight loss in the long term. Conclusions: The results indicate that the same restrictive practices can have different effects depending on the BMI and the sex of the subjects.

P300 in alcohol dependence: Effects of TaqI-A genotype

Background and Objectives: TaqI-A polymorphism, related to D2 dopamine receptor (DRD2), and event-related P300 potentials have been considered markers of alcohol dependence. The effect of alcohol use variables and TaqI-A on P300 in a single sample have been hardly analysed previously. This study examined changes in P300 parameters after six months of abstinence in alcohol-dependent subjects classified by their TaqI-A genotype. Methods: 102 men with alcohol dependence were studied at baseline and at 6 months of continued abstinence. P300 was recorded using an auditory paradigm. TaqI-A polymorphism was genotyped: 34.3% of sample was classified as A1[TaqI-A1/TaqI-A1and TaqI-A1/TaqI-A2] and 65.7% as A2 [TaqI-A2/TaqI-A2]. The association between P300 and TaqI-A and the correlation with age and alcohol consumption were considered. Results: The abstinence period was not associated to differences in neither P300 latency (F[1, 99] = 1.154 p = 0.285) nor amplitude (F[1, 99] = 1.453, p = 0.231). A1 subgroup was related to a longer latency (F[1, 99] = 5.055 p = 0.027), an early abuse age onset (F[1, 100] = 14.552 p <0.001) and close to be significant to an early dependence age onset (F[1, 100] = 3.868 p = 0.052). Other drinking pattern variables were not associated to p300 measures. Family history for alcoholism and TaqI-A were not related (X[1] = 0.327 p = 0.568) and no association was found with p300 measures. Current age correlated positively with P300 latency (F[1, 99] = 26.082, p <0,001) and negatively with amplitude (F[1, 99] = 5.297 p = 0.023). P300 amplitude was not influenced by alcohol use variables nor TaqI-A polymorphism. Conclusions: P300 latency could be a biological marker of vulnerability to alcohol dependence related to TaqI-A1 polymorphism, irrespective of alcohol use variables.

Delusions of Pregnancy with Post-Partum Onset: An Integrated, Individualized View

Background and Objectives: Bizarre hypochondriacal delusion is an important content of delusion of pregnancy during post-partum period. Methods: Here we report two cases with postpartum delusion of pregnancy; one with pre-existing schizophrenia and another one with family history of pseudocyesis and schizoaffective disorder but with no pre-existing psychiatric illness. Results: Nosological, phenomenological and aetiological issues are discussed. In the context of novel deficit-and motivational theories of delusion formation we provide an integrated view of the reported cases. Conclusions: The complexity of the delusion of pregnancy should be considered in the treatment planning-particularly in the post-partum period.

Neurobiological underpinnings of suicidal behavior: Integrating data from clinical and biological studies

Background and Objectives: Every year, suicide accounts for approximately one million preventable deaths worldwide. Suicidal behavior is complex and multi-determined with risk factors identified in multiple domains including clinical, genetic, environmental, behavioral, neurophysiological, and neurocognitive. Modeling causal pathways that integrate these factors may assist in better identification of high-risk individuals would allow for effective preventive intervention. Methods: Published literature in the English language was reviewed to identify evidence supporting a multi-dimensional model of putative causal pathways for suicidal behavior. Results: There is evidence that clinical, neurochemical, neuroendocrine, neurocognitive, and neurophysiological contributory factors may be useful as intermediate phenotypes in describing putative causal pathways from genetics and early-life adversity to suicidal acts. Conclusions: Determining the causes of suicidal behavior involves integrating risk factors from multiple domains.