Psychological Medicine最新文献

{"title":"Effort-based decision-making in ultra-high-risk for psychosis and bipolar disorder.","authors":"E Bora, E Cesim, M S Eyuboglu, M Demir, B Yalincetin, C Ermis, S Özbek Uzman, E Sut, C Demirlek, B Verim, B Baykara, N İnal, B B Akdede","doi":"10.1017/S003329172400134X","DOIUrl":"https://doi.org/10.1017/S003329172400134X","url":null,"abstract":"<p><strong>Background: </strong>Effort-based decision-making has been proposed as a potential mechanism contributing to transdiagnostic motivational deficits in psychotic disorder and bipolar disorder. However, very limited information is available about deficits in effort-cost-decision-making in the early stages of psychotic disorder and no study has investigated effort allocation deficits before the onset of bipolar disorder. Our aim was to investigate effort-based-decision-making in ultra-high-risk for psychosis (UHR-P) and bipolar disorder (UHR-BD).</p><p><strong>Methods: </strong>Effort-cost decision-making performance was evaluated in UHR-P (<i>n</i> = 72) and UHR-BD (<i>n</i> = 68) and healthy controls (<i>n</i> = 38). Effort-Expenditure for Reward Task (EEfRT) was used.</p><p><strong>Results: </strong>Compared to controls, both UHR-P and UHR-BD groups were associated with a reduced possibility to choose the harder task when the reward magnitudes and/or the likelihood of receiving the reward were high. In both groups, effort allocation abnormalities were associated with poor social functioning.</p><p><strong>Conclusions: </strong>The current findings suggest that difficulties in effort-cost computation are transdiagnostic markers of illness liability in psychotic and bipolar disorders. In early intervention services, effort-based decision-making abnormalities should be considered as a target for interventions to manage motivational deficits in individuals at high risk for psychosis and BD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between keystroke and stylus metadata and depressive symptoms in adolescents.","authors":"Moonyoung Jang, Youngeun Cho, Do Hyung Kim, Sunghyun Park, Seonghyeon Park, Ji-Won Hur, Minah Kim, Kwangsu Cho, Chang-Gun Lee, Jun Soo Kwon","doi":"10.1017/S0033291724001260","DOIUrl":"https://doi.org/10.1017/S0033291724001260","url":null,"abstract":"<p><strong>Background: </strong>Adolescents often experience a heightened incidence of depressive symptoms, which can persist without early intervention. However, adolescents often struggle to identify depressive symptoms, and even when they are aware of these symptoms, seeking help is not always their immediate response. This study aimed to explore the relationship between passively collected digital data, specifically keystroke and stylus data collected via mobile devices, and the manifestation of depressive symptoms.</p><p><strong>Methods: </strong>A total of 927 first-year middle school students from schools in Seoul solved Korean language and math problems. Throughout this study, 77 types of keystroke and stylus data were collected, including parameters such as the number of key presses, tap pressure, stroke speed, and stroke acceleration. Depressive symptoms were measured using the self-rated Patient Health Questionnaire-9 (PHQ-9).</p><p><strong>Results: </strong>Multiple regression analysis highlighted the significance of stroke length, speed, and acceleration, the average <i>y</i>-coordinate, the tap pressure, and the number of incorrect answers in relation to PHQ-9 scores. The keystroke and stylus metadata were able to reflect mood, energy, cognitive abilities, and psychomotor symptoms among adolescents with depressive symptoms.</p><p><strong>Conclusions: </strong>This study demonstrates the potential of automatically collected data during school exams or classes for the early screening of clinical depressive symptoms in students. This study has the potential to serve as a cornerstone in the development of digital data frameworks for the early detection of depressive symptoms in adolescents.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social relationship factors, depressive symptoms, and incident dementia: a prospective cohort study into their interrelatedness.","authors":"Lukas A Duffner, Kay Deckers, Dorina Cadar, Marjolein E de Vugt, Sebastian Köhler","doi":"10.1017/S0033291724001272","DOIUrl":"https://doi.org/10.1017/S0033291724001272","url":null,"abstract":"<p><strong>Background: </strong>Different aspects of social relationships (e.g., social network size or loneliness) have been associated with dementia risk, while their overlap and potentially underlying pathways remain largely unexplored. This study therefore aimed to (1) discriminate between different facets of social relationships by means of factor analysis, (2) examine their associations with dementia risk, and (3) assess mediation by depressive symptoms.</p><p><strong>Methods: </strong>Thirty-six items from questionnaires on social relationships administered in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing (<i>n</i> = 7536) were used for exploratory and confirmatory factor analysis. Factors were then used as predictors in Cox proportional hazard models with dementia until Wave 9 as outcome, adjusted for demographics and cardiovascular risk factors. Structural equation modeling tested mediation by depressive symptoms through effect decomposition.</p><p><strong>Results: </strong>Factor analyses identified six social factors. Across a median follow-up time of 11.8 years (IQR = 5.9-13.9 years), 501 people developed dementia. Higher factor scores for frequency and quality of contact with children (HR = 0.88; <i>p</i> = 0.021) and more frequent social activity engagement (HR = 0.84; <i>p</i> < 0.001) were associated with lower dementia risk. Likewise, higher factor scores for loneliness (HR = 1.13; <i>p</i> = 0.011) and negative experiences of social support (HR = 1.10; <i>p</i> = 0.047) were associated with higher dementia risk. Mediation analyses showed a significant partial effect mediation by depressive symptoms for all four factors. Additional analyses provided little evidence for reverse causation.</p><p><strong>Conclusions: </strong>Frequency and quality of social contacts, social activity engagement, and feelings of loneliness are associated with dementia risk and might be suitable targets for dementia prevention programs, partly by lowering depressive symptoms.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of virtual reality in bipolar disorder: a systematic review.","authors":"Gonzalo Salazar de Pablo, Omar Rios Hernandez, Sandra Gómez Vallejo, Allan H Young, Matteo Cella, Lucia Valmaggia","doi":"10.1017/S0033291724001247","DOIUrl":"https://doi.org/10.1017/S0033291724001247","url":null,"abstract":"<p><p>Virtual reality (VR) is a technology that allows to interact with recreated digital environments and situations with enhanced realism. VR has shown good acceptability and promise in different mental health conditions. No systematic review has evaluated the use of VR in Bipolar Disorder (BD). This PRISMA-compliant systematic review searched PubMed and Web of Science databases (PROSPERO: CRD42023467737) to identify studies conducted in individuals with BD in which VR was used. Results were systematically synthesized around four categories (cognitive and functional evaluation, clinical assessment, response to VR and safety/acceptability). Eleven studies were included (267 individuals, mean age = 36.6 years, 60.7% females). Six studies using VR to carry out a cognitive evaluation detected impairments in neuropsychological performance and delayed reaction times. VR was used to assess emotional regulation. No differences in well-being between VR-based and physical calm rooms were found. A VR-based stress management program reduced subjective stress, depression, and anxiety levels. VR-based cognitive remediation improved cognition, depressive symptoms, and emotional awareness. 48.7% of the individuals with BD considered VR-based cognitive remediation 'excellent', whereas 28.2% considered it 'great'. 87.2% of individuals did not report any side effects. 81.8% of studies received a global quality rating of moderate. Emerging data point towards a promising use of VR in BD as an acceptable assessment/intervention tool. However, multiple unstudied domains as comorbidity, relapse and prodromal symptoms should be investigated. Research on children and adolescents is also recommended. Further research and replication of findings are required to disentangle which VR-interventions for which populations and outcomes are effective.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct trajectories of neuropsychiatric symptoms in the 12 months following traumatic brain injury (TBI): a TRACK-TBI study.","authors":"Karen A Martinez, Ehri Ryu, Christopher J Patrick, Nancy R Temkin, Murray B Stein, Brooke E Magnus, Michael A McCrea, Geoffrey T Manley, Lindsay D Nelson","doi":"10.1017/S0033291724001211","DOIUrl":"https://doi.org/10.1017/S0033291724001211","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric symptoms are common after traumatic brain injury (TBI) and often resolve within 3 months post-injury. However, the degree to which individual patients follow this course is unknown. We characterized trajectories of neuropsychiatric symptoms over 12 months post-TBI. We hypothesized that a substantial proportion of individuals would display trajectories distinct from the group-average course, with some exhibiting less favorable courses.</p><p><strong>Methods: </strong>Participants were level 1 trauma center patients with TBI (<i>n</i> = 1943), orthopedic trauma controls (<i>n</i> = 257), and non-injured friend controls (<i>n</i> = 300). Trajectories of six symptom dimensions (Depression, Anxiety, Fear, Sleep, Physical, and Pain) were identified using growth mixture modeling from 2 weeks to 12 months post-injury.</p><p><strong>Results: </strong>Depression, Anxiety, Fear, and Physical symptoms displayed three trajectories: Stable-Low (86.2-88.6%), Worsening (5.6-10.9%), and Improving (2.6-6.4%). Among symptomatic trajectories (Worsening, Improving), lower-severity TBI was associated with higher prevalence of elevated symptoms at 2 weeks that steadily resolved over 12 months compared to all other groups, whereas higher-severity TBI was associated with higher prevalence of symptoms that gradually worsened from 3-12 months. Sleep and Pain displayed more variable recovery courses, and the most common trajectory entailed an average level of problems that remained stable over time (Stable-Average; 46.7-82.6%). Symptomatic Sleep and Pain trajectories (Stable-Average, Improving) were more common in traumatically injured groups.</p><p><strong>Conclusions: </strong>Findings illustrate the nature and rates of distinct neuropsychiatric symptom trajectories and their relationship to traumatic injuries. Providers may use these results as a referent for gauging typical <i>v.</i> atypical recovery in the first 12 months post-injury.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive functions in psychopathy: a meta-analysis of inhibition, planning, shifting, and working memory performance.","authors":"Matthias Burghart, Sergej Schmidt, Daniela Mier","doi":"10.1017/S0033291724001259","DOIUrl":"https://doi.org/10.1017/S0033291724001259","url":null,"abstract":"<p><p>Much research has focused on executive function (EF) impairments in psychopathy, a severe personality disorder characterized by a lack of empathy, antisocial behavior, and a disregard for social norms and moral values. However, it is still unclear to what extent EF deficits are present across psychopathy factors and, more importantly, which EF domains are impaired. The current meta-analysis answers these questions by synthesizing the results of 50 studies involving 5,694 participants from 12 different countries. Using multilevel random-effects models, we pooled effect sizes (Cohen's <i>d</i>) for five different EF domains: overall EF, inhibition, planning, shifting, and working memory. Moreover, differences between psychopathy factors were evaluated. Our analyses revealed <i>small</i> deficits in overall EF, inhibition, and planning performance. However, a closer inspection of psychopathy factors indicated that EF deficits were specific to lifestyle/antisocial traits, such as disinhibition. Conversely, interpersonal/affective traits, such as boldness, showed no deficits and in some cases even improved EF performance. These findings suggest that EF deficits are <i>not</i> a key feature of psychopathy per se, but rather are related to antisociality and disinhibitory traits. Potential brain correlates of these findings as well as implications for future research and treatment are discussed.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-wide meta-analysis of ascertainment and symptom structures of major depression in case-enriched and community cohorts.","authors":"Mark J Adams, Jackson G Thorp, Bradley S Jermy, Alex S F Kwong, Kadri Kõiv, Andrew D Grotzinger, Michel G Nivard, Sally Marshall, Yuri Milaneschi, Bernhard T Baune, Bertram Müller-Myhsok, Brenda W J H Penninx, Dorret I Boomsma, Douglas F Levinson, Gerome Breen, Giorgio Pistis, Hans J Grabe, Henning Tiemeier, Klaus Berger, Marcella Rietschel, Patrik K Magnusson, Rudolf Uher, Steven P Hamilton, Susanne Lucae, Kelli Lehto, Qingqin S Li, Enda M Byrne, Ian B Hickie, Nicholas G Martin, Sarah E Medland, Naomi R Wray, Elliot M Tucker-Drob, Cathryn M Lewis, Andrew M McIntosh, Eske M Derks","doi":"10.1017/S0033291724001880","DOIUrl":"10.1017/S0033291724001880","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic criteria for major depressive disorder allow for heterogeneous symptom profiles but genetic analysis of major depressive symptoms has the potential to identify clinical and etiological subtypes. There are several challenges to integrating symptom data from genetically informative cohorts, such as sample size differences between clinical and community cohorts and various patterns of missing data.</p><p><strong>Methods: </strong>We conducted genome-wide association studies of major depressive symptoms in three cohorts that were enriched for participants with a diagnosis of depression (Psychiatric Genomics Consortium, Australian Genetics of Depression Study, Generation Scotland) and three community cohorts who were not recruited on the basis of diagnosis (Avon Longitudinal Study of Parents and Children, Estonian Biobank, and UK Biobank). We fit a series of confirmatory factor models with factors that accounted for how symptom data was sampled and then compared alternative models with different symptom factors.</p><p><strong>Results: </strong>The best fitting model had a distinct factor for <i>Appetite/Weight</i> symptoms and an additional measurement factor that accounted for the skip-structure in community cohorts (use of Depression and Anhedonia as gating symptoms).</p><p><strong>Conclusion: </strong>The results show the importance of assessing the directionality of symptoms (such as hypersomnia versus insomnia) and of accounting for study and measurement design when meta-analyzing genetic association data.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental risk factors for schizophrenia and bipolar disorder from childhood to diagnosis: a Swedish nested case-control study.","authors":"Natassia Robinson, Alexander Ploner, Marica Leone, Paul Lichtenstein, Kenneth S Kendler, Sarah E Bergen","doi":"10.1017/S0033291724000266","DOIUrl":"10.1017/S0033291724000266","url":null,"abstract":"<p><strong>Background: </strong>Shared genetic risk between schizophrenia (SCZ) and bipolar disorder (BD) is well-established, yet the extent to which they share environmental risk factors remains unclear. We compare the associations between environmental exposures during childhood/prior to disorder onset with the risk of developing SCZ and BD.</p><p><strong>Methods: </strong>We conducted a Swedish register-based nested case-control study using 4184 SCZ cases and 18 681 BD cases diagnosed 1988-2013. Cases were matched to five controls by birth year, birth region, and sex. Conditional logistic regression was used to estimate incidence rate ratios (IRR) for SCZ and BD for each exposure (severe childhood infections, adverse childhood experiences (ACEs), substance use disorders (SUDs), urban birth/longest residence).</p><p><strong>Results: </strong>All SUD types were associated with very high risk (IRR 4.9-25.5), and all forms of ACEs with higher risk (IRR 1.5-4.3) for both disorders. In the mutually adjusted models, ACEs demonstrated slightly higher risk for BD (SCZ IRR 1.30, 1.19-1.42; BD IRR 1.49, 1.44-1.55), while for SUD, risk was higher for SCZ (SCZ IRR 9.43, 8.15-10.92; BD IRR 5.50, 5.15-5.88). Infections were associated with increased risk of BD (IRR 1.21, 1.17-1.26) but not SCZ. Urban birth and urban longest residence were associated with higher risk of SCZ (IRR 1.19, 1.03-1.37), while only the combination of urban birth and rural longest residence showed higher risk for BD (IRR 1.24, 1.13-1.35).</p><p><strong>Conclusions: </strong>There were both shared and unique environmental risk factors: SUDs and ACEs were risk factors for both disorders, while infections were more strongly associated with BD and urbanicity with SCZ.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up.","authors":"Carmen Simonsen, Gina Åsbø, Mike Slade, Kristin Fjelnseth Wold, Line Widing, Camilla Bärthel Flaaten, Magnus Johan Engen, Siv Hege Lyngstad, Erlend Gardsjord, Thomas Bjella, Kristin Lie Romm, Torill Ueland, Ingrid Melle","doi":"10.1017/S0033291724000205","DOIUrl":"10.1017/S0033291724000205","url":null,"abstract":"<p><strong>Background: </strong>More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap.</p><p><strong>Methods: </strong>FEP participants (<i>n</i> = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year).</p><p><strong>Results: </strong>In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ²). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none.</p><p><strong>Conclusions: </strong>In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of depression and use of alcohol and other drugs after partner suicide in the association between suicide bereavement and suicide: cohort study in the Danish population.","authors":"Alexandra Pitman, Keltie McDonald, Yanakan Logeswaran, Glyn Lewis, Julie Cerel, Gemma Lewis, Annette Erlangsen","doi":"10.1017/S0033291724000448","DOIUrl":"10.1017/S0033291724000448","url":null,"abstract":"<p><strong>Background: </strong>Although suicide bereavement is associated with suicide and self-harm, evidence regarding mechanisms is lacking. We investigated whether depression and substance use (alcohol and/or other drugs) explain the association between partner suicide bereavement and suicide.</p><p><strong>Methods: </strong>Linkage of nationwide, longitudinal data from Denmark for the period 1980-2016 facilitated a comparison of 22 668 individuals exposed to bereavement by a partner's suicide with 913 402 individuals bereaved by a partner's death due to other causes. Using causal mediation models, we estimated the degree to which depression and substance use (considered separately) mediated the association between suicide bereavement and suicide.</p><p><strong>Results: </strong>Suicide-bereaved partners were found to have a higher risk of suicide (HR_adj = 1.59, 95% CI 1.36-1.86) and of depression (OR_adj 1.16, 95% CI 1.09-1.25) when compared to other-bereaved partners, but a lower risk of substance use (OR_adj 0.83; 95% CI 0.78-0.88). An increased risk of suicide was found among any bereaved individuals with a depression diagnosis recorded post-bereavement (OR_adj 3.92, 95% CI 3.55-4.34). Mediation analysis revealed that depression mediated 2% (1.68%; 95% CI 0.23%-3.14%; <i>p</i> = 0.024) of the association between suicide bereavement and suicide in partners when using bereaved controls.</p><p><strong>Conclusions: </strong>Depression is a partial mediator of the association between suicide bereavement and suicide. Efforts to prevent and optimize the treatment of depression in suicide-bereaved people could reduce their suicide risk. Our findings might be conservative because we did not include cases of depression diagnosed in primary care. Further work is needed to understand this and other mediators.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}