Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-30T20:32:21.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Lifetime Subthreshold Mania is Related to Suicidality in Posttraumatic Stress Disorder

Published online by Cambridge University Press:  07 November 2014

Liliana Dell'Osso ,
Claudia Carmassi ,
Paola Rucci ,
Antonio Ciapparelli ,
Rosemma Paggini ,
Carla Emilia Ramacciotti ,
Ciro Conversano ,
Matteo Balestrieri  and
Donatella Marazziti
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Although the association between mood disorders, and particularly bipolar disorders, comorbidity and suicidality in posttraumatic (PTSD) patients is well established, less information is available on the impact of subsyndromal mood symptoms. The aim of the present study was, thus, to explore the frequency and relationship between subthreshold mood symptoms, assessed by a specific and validated questionnaire, and suicidality in PTSD patients.

Method: Sixty-five PTSD outpatients without bipolar disorders and 65 healthy control subjects were asked to complete the Mood Spectrum-SR-Lifetime Version (MOODS-SR), a questionnaire exploring the presence of subthreshold affective symptoms. Logistic regression models were used to analyze the relationships between suicidality, explored by six items of the MOODS-SR combined and dichotomized to denote the presence or absence of suicidal ideations/plans and/or attempts, and the number of manic/hypomanic or depressive symptoms.

Results: Statistically significant and positive associations were found between the presence of manic/hypomanic and depressive symptoms and the likelihood of suicidal ideation or attempts.

Conclusion: Besides depressive, even subthreshold manic/hypomanic features seem to be associated with higher suicidality in PTSD patients.

Type
Original Research
Information
CNS Spectrums , Volume 14 , Issue 5 , May 2009 , pp. 262 - 266
Copyright
Copyright © Cambridge University Press 2009

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.)

References

REFERENCES

1.Davidson, JR, Hughes, D, Blazer, DG, George, LK. Post-traumatic stress disorder in the community: an epidemiological study. Psychol Med. 1991;21:713–721.CrossRefGoogle ScholarPubMed
2.Marshall, RD, Olfson, M, Hellman, F, Blanco, C, Guardino, M, Struening, EL. Comorbidity, impairment, and suicidality in subthreshold PTSD. Am J Psychiatry. 2001;158:1467–1473.CrossRefGoogle ScholarPubMed
3.Oquendo, M, Brent, DA, Birmaher, B, et al.Posttraumatic stress disorder comorbid with major depression: factors mediating the association with suicidal behavior. Am J Psychiatry. 2005;162:560–566.CrossRefGoogle ScholarPubMed
4.Simon, NM, Otto, MW, Wisniewski, SR, et al.Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry. 2004;161:2222–2229.Google Scholar
5.Dilsaver, SC, Benazzi, F, Akiskal, HS, Akiskal, KK. Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality. Bipolar Disord. 2007;9:649–655.Google Scholar
6.Akiskal, HS, Bourgeois, ML, Angst, J, Post, R, Möller, H, Hirschfeld, R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord. 2000;59(suppl 1):S5–S30.Google Scholar
7.Akiskal, HS. Classification, diagnosis and boundaries of bipolar disorders. In: Maj, M, Akiskal, HS, Lopez-Ibor, JJ, Sartorius, N, eds. Bipolar Disorder. London, UK: John Wiley & Sons; 2002:1–52Google Scholar
8.Judd, LL, Akiskal, HS. The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord. 2003;73:123–131.Google Scholar
9.Angst, J, Cassano, G. The mood spectrum: improving the diagnosis of bipolar disorder. Bipolar Disord. 2005:7(suppl 4):4–12.CrossRefGoogle ScholarPubMed
10.Dell'Osso, L, Armani, A, Rucci, P, et al.Measuring mood spectrum: comparison of interview (SCI-MOODS) and self-report (MOODS-SR) instrumentst. Compr Psychiatry. 2002;43:69–73.Google Scholar
11.Cassano, GB, Rucci, P, Frank, E, et al.The mood spectrum in unipolar and bipolar disorder: arguments for a unitary approach. Am J Psychiatry. 2004;161:1264–1269.Google Scholar
12.Balestrieri, M, Rucci, P, Sbrana, A, et al.Lifetime rhythmicity and mania as correlates of suicidal ideation and attempts in mood disorders. Compr Psychiatry. 2006;47:334–341.Google Scholar
13.Dell'Osso, L, Shear, MK, Carmassi, C, et al.Validity and reliability of the Structured Clinical Interview for the Trauma and Loss Spectrum (SCI-TALS). Clin Pract Epidemol Ment Health. 2008;4:2.Google Scholar
14.First, MB, Spitzer, RL, Williams, JBW, Gibbon, M. Structured Clinical Interview for DSM-IV-Patient Edition (SCID-P). Washington, DC: American Psychiatric Press; 1995.Google Scholar
15.Gray, MJ, Litz, BT, Hsu, JL, Lombardo, TW. Psychometric properties of the life events checklist. Assessment. 2004;11:330–341.Google Scholar
16.Kaplan, MS, Huguet, N, McFarland, BH, Newsom, JT. Suicide among male veterans: a prospective population-based study. J Epidemiol Community Health. 2007;61:619–624.CrossRefGoogle ScholarPubMed
17.Zivin, K, Kim, HM, McCarthy, JF, et al.Suicide mortality among individuals receiving treatment for depression in the Veterans Affairs health system: associations with patient and treatment setting characteristics. Am J Public Health. 2007;97:2193–2198.CrossRefGoogle ScholarPubMed
18.Freeman, TW, Roca, V, Moore, WM. A comparison of chronic combat-related posttraumatic stress disorder (PTSD) patients with and without a history of suicide attempt. J Nerv Ment Dis. 2000;188:460–463.Google Scholar
19.Oquendo, MA, Friend, JM, Halberstam, B, et al.Association of comorbid posttraumatic stress disorder and major depression with greater risk for suicidal behavior. Am J Psychiatry. 2003;160:580–582.Google Scholar
20.Garno, JL, Goldberg, JF, Ramirez, PM, Ritzier, BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121–125.Google Scholar
21.Joiner, TE Jr, Rudd, MD, Rajab, MH. Agreement between self- and clinician-rated suicidal symptoms in a clinical sample of young adults: explaining discrepancies. J Consult Clin Psychol. 1999;67:171–176.CrossRefGoogle Scholar