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Maurizio Pompili - One of the best experts on this subject based on the ideXlab platform.
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differential associations of Affective temperaments and diagnosis of Major Affective Disorders with suicidal behavior
Journal of Affective Disorders, 2017Co-Authors: Ross J Baldessarini, Maurizio Pompili, Marco Innamorati, Denise Erbuto, Gianluca Serafini, Andrea Fiorillo, Mario Amore, Paolo GirardiAbstract:Abstract Background Affective temperaments are associated with suicidal risk, but their predictive value relative to diagnosis of Major Affective Disorder is uncertain. Methods We compared diagnoses, Affective-temperament ratings (TEMPS-A), and other potential risk factors in 956 psychiatric inpatients, using bivariate analyses and multivariable logistic regression modeling for associations with suicidal status. Results Lifetime suicide-attempt rates were high (43.9% overall), ranking by diagnosis: bipolar-II (58.4%), Major depressive (50.0%), bipolar-I (44.6%), other (38.0%), and psychotic (33.9%) Disorders. TEMPS-A scores for depressive ( dep ), cyclothymic ( cyc ), irritable ( irr ), and anxious ( anx ) temperaments and their sum were strongly associated with suicidal risk; hyperthymic ( hyp ) temperament scores were inversely associated; and a composite measure ( dep+cyc+irr+anx – hyp ), even more strongly associated. The composite score was highly, independently associated with suicidal behavior ( p p =0.0002), but older age and diagnosis of Major Affective Disorder, much less (both p =0.02). Conclusions Measures of Affective temperament-types were independently and more strongly associated with lifetime suicide attempt than was diagnosis of a Major Affective Disorder. However, in this hospitalized cohort, suicide rates were high across diagnoses, possibly limiting the predictive value of diagnosis.
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suicidal behavior in bipolar Disorder epidemiology characteristics and Major risk factors
Journal of Affective Disorders, 2012Co-Authors: Xenia Gonda, Maurizio Pompili, Gianluca Serafini, Paolo Girardi, Franco Montebovi, Sandra Campi, Peter Dome, Timea Duleba, Zoltan RihmerAbstract:Abstract Background Suicide is one of the leading causes of death and a Major public health problem worldwide, and the Majority of suicide attempters and completers suffer from some Major Affective Disorder at the time of their death, which, in the Majority of cases is unrecognized, under- or misdiagnosed and untreated. Methods: Based on a systematic literature search, the authors give a detailed and critical overview of established risk factors of suicide in bipolar Disorder. Results Among Affective Disorders, bipolar Disorder carries the highest risk of suicide, yet not all bipolar patients commit or even attempt suicide during their illness. While the general suicide risk factors also apply for bipolar Disorders, there are several disease-specific risk factors as well which should be taken into account when evaluating suicide risk in case of patients. Conclusion: It is crucial to identify suicide risk factors in bipolar Disorder to be able to differentiate those patients within this already increased-risk illness group who are at especially high risk and therefore to allow for better prediction and prevention of suicidal acts.
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Affective temperamental profiles are associated with white matter hyperintensity and suicidal risk in patients with mood Disorders
Journal of Affective Disorders, 2011Co-Authors: Gianluca Serafini, Maurizio Pompili, Marco Innamorati, Paolo Fusarpoli, Hagop S Akiskal, Zoltan Rihmer, David Lester, Andrea Romano, Irismar Reis De OliveiraAbstract:BACKGROUND: Patients with white matter hyperintensities (WMH) may be at higher risk for Affective Disorders and suicide. Affective temperaments may play a significant role in mood Disorders. This study aimed to evaluate the eventual association between WMH, Affective temperaments and suicidal behaviour in Major Affective Disorder. METHODS: A total of 318 patients with Major Affective Disorders were consecutively admitted as psychiatric inpatient. A total of 247 were included and given, brain magnetic resonance imaging (MRI) and assessed with the Mini International Neuropsychiatric Interview (MINI), the Beck Hopelessness Scale (BHS), the Hamilton Depression Rating Scale (HDRS(17)), the Young Mania Rating Scale (YMRS) and the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). RESULTS: A total of 48% of patients had periventricular WMH (PWMH) and 39% of them had deep WMH (DWMH). Patients with higher dysthymia and lower hyperthymia (H-DCIA group) were more likely to have higher BHS scores (BHS>/=9=77% vs. 52%; p>0.001), more WMH (46% vs. 29%; chi(2)(n=)(3)=9.90; p Language: en
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decreased risk of suicides and attempts during long term lithium treatment a meta analytic review
Bipolar Disorders, 2006Co-Authors: Ross J Baldessarini, Leonardo Tondo, Paula Davis, Maurizio Pompili, Frederick K Goodwin, John HennenAbstract:Objectives: To update and extend comparisons of rates of suicides and suicide attempts among patients with Major Affective Disorders with versus without long-term lithium treatment. Methods: Broad searching yielded 45 studies providing rates of suicidal acts during lithium treatment, including 34 also providing rates without lithium treatment. We scored study quality, tested between-study variance, and examined suicidal rates on versus off lithium by meta-analytic methods to determine risk ratios (RRs) and 95% confidence intervals (CI). Results: In 31 studies suitable for meta-analysis, involving a total of 85,229 person-years of risk-exposure, the overall risk of suicides and attempts was five times less among lithium-treated subjects than among those not treated with lithium (RR = 4.91, 95% CI 3.82–6.31, p < 0.0001). Similar effects were found with other meta-analytic methods, as well as for completed versus attempted suicide, and for bipolar versus Major mood Disorder patients. Studies with higher quality ratings, including randomized, controlled trials, involved shorter exposures with somewhat lesser lithium superiority. Omitting one very large study or those involving lithium-discontinuation had little effect on the results. The incidence-ratio of attempts-to-suicides increased 2.5 times with lithium-treatment, indicating reduced lethality of suicidal acts. There was no indication of bias toward reporting positive findings, nor were outcomes significantly influenced by publication-year or study size. Conclusions: Risks of completed and attempted suicide were consistently lower, by approximately 80%, during treatment of bipolar and other Major Affective Disorder patients with lithium for an average of 18 months. These benefits were sustained in randomized as well as open clinical trials.
Nicholas John Craddock - One of the best experts on this subject based on the ideXlab platform.
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evidence for familial cosegregation of Major Affective Disorder and genetic markers flanking the gene for darier s disease
Molecular Psychiatry, 2002Co-Authors: Ian Jones, Michael John Owen, Nicholas James Olaf Jacobsen, Elaine K Green, Gareth Elvidge, Nicholas John CraddockAbstract:Darier's disease is a rare autosomal dominantly inherited keratosis.1 We have previously reported a family in which Major Affective Disorder co-segregated with Darier's disease, consistent with linkage between the Darier gene and a susceptibility locus for Affective illness (max lod = 2.1).2 The Darier gene has been mapped to 12q 23–q24.1 and identified as ATP2A2, a gene encoding SERCA2—a sarcoplasmic/endoplasmic reticulum calcium pump that plays a role in intracellular calcium signalling.3 A number of groups have reported independent evidence of linkage between bipolar Disorder and markers in this region.4 We here describe a further Caucasian family of European origin in which there is co-occurrence of Darier's disease and Major Affective Disorder including bipolar Disorder and report the results of linkage analysis employing genetic markers flanking the Darier's gene. The pedigree includes two individuals with mood Disorder from a branch of the family not affected with Darier's disease. However, there is a new mutation in the Darier (ATP2A2) gene in this family and all individuals affected by mood Disorder show co-segregation with a haplotype in the region of the Darier's gene (max lod = 3.58). The family provides strong evidence against the Darier-causing mutation itself playing a Major role in Affective Disorder but strongly supports the existence of a bipolar Disorder susceptibility gene in the Darier region.
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familial cosegregation of Major Affective Disorder and darier s disease keratosis follicularis
British Journal of Psychiatry, 1994Co-Authors: Nicholas John Craddock, Michael John Owen, Susan Burge, B Kurian, Pramod Thomas, P McguffinAbstract:Darier's disease is a rare autosomal dominantly inherited keratosis. This is an account of one family in which there is co-occurrence of Major Affective Disorder and Darier's disease in five members and absence of both Disorders in five members. The pedigree is consistent with genetic linkage between the Darier gene and a Major autosomal dominant susceptibility locus for Major Affective Disorder. When the Darier's disease gene has been mapped, its chromosomal location will be an interesting candidate locus for linkage studies of Major Affective Disorder.
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the gene for darier s disease maps to chromosome 12q23 q24 1
Human Molecular Genetics, 1993Co-Authors: Nicholas John Craddock, Susan Burge, Elisabeth Dawson, Queta Roberts, Jo Daniels, Liz Parfitt, Becky Mant, Michael Gill, Peter Mcguffin, John PowellAbstract:Darier's disease is a rare autosomal dominant skin Disorder in which there is abnormal adhesion between keratinocytes. It appears to be associated with an increased prevalence of neuropsychiatric Disorders including mental retardation and epilepsy. In addition we have previously reported a family in which Major Affective Disorder cosegregates with Darier's disease. In the present study we have localized the gene for Darier's disease to chromosome 12q23-q24.1 by linkage analysis in five British pedigrees. We obtained a maximum two point lod score of 4.29 with marker D12S84 at zero recombination fraction. All five families showed evidence of linkage between the disease gene and markers in this region. Subsequent identification of the Darier's disease gene will provide insights into normal mechanisms of cell adhesion and may be of importance in the genetic investigation of neuropsychiatric Disorders as well as elucidating the pathogenesis of Darier's disease itself.
Flemming Morkeberg Nilsson - One of the best experts on this subject based on the ideXlab platform.
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on the increased risk of developing late onset epilepsy for patients with Major Affective Disorder
Journal of Affective Disorders, 2003Co-Authors: Flemming Morkeberg Nilsson, Lars Vedel Kessing, Tom G BolwigAbstract:Abstract Background: Based on register data we wanted to investigate whether patients with a diagnosis of Affective Disorder are at increased risk of developing epilepsy compared to other medically ill control groups. Methods: By linkage of public hospital registers covering the whole of Denmark from 1977 to 1993, using ICD-8 diagnoses, three study cohorts were identified: Patients with first Affective Disorder episodes (mania and depression), patients with first osteoarthritis and patients with first diabetes discharge. Time to first diagnosis of epilepsy was estimated with the use of survival analysis. Results: A total of 164,227 patients entered the study base: 13,748 patients with mania or depression, 81,380 patients with osteoarthritis and 69,149 patients with diabetes. The risk of getting a diagnosis of epilepsy was increased for patients with Affective Disorder compared with the risk for the control groups. However, the increased risk seemed to be due to the effect of comorbid alcohol or drug abuse and not to the effect of the Affective illness itself. Limitations: The results only apply to hospitalised patients. Diagnoses are not validated for research purposes. Conclusion: Patients with a diagnosis of Affective Disorder have an increased risk of developing epilepsy in later life. In patients with Affective Disorder, comorbid alcoholism/drug abuse seriously increased the risk of a subsequent diagnosis of epilepsy.
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increased risk of developing parkinson s disease for patients with Major Affective Disorder a register study
Acta Psychiatrica Scandinavica, 2001Co-Authors: Flemming Morkeberg Nilsson, Lars Vedel Kessing, Tom G BolwigAbstract:Objective: To investigate whether patients with a diagnosis of Affective Disorder are at an increased risk of developing Parkinson's disease compared with medically ill control groups. Method: By linkage of public hospital registers from 1977 to 1993, three study cohorts were identified: patients with Affective Disorder episodes (mania or depression) and patients with osteoarthritis or diabetes. Time to the first diagnosis of Parkinson's disease was estimated with the use of survival analysis. Results: A total of 164 385 patients entered the study base. The risk of being given a diagnosis of Parkinson's disease was significantly increased for patients with Affective Disorder, odds ratio 2.2 (CI 95% 1.7–2.8) compared with osteoarthritis, and depressive Disorders, odds ratio 2.2 (CI 95% 1.7–2.9) compared with osteoarthritis. Conclusion: This study supports the hypothesis of a common aetiology for Major Affective Disorder and Parkinson's disease.
Ross J Baldessarini - One of the best experts on this subject based on the ideXlab platform.
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differential associations of Affective temperaments and diagnosis of Major Affective Disorders with suicidal behavior
Journal of Affective Disorders, 2017Co-Authors: Ross J Baldessarini, Maurizio Pompili, Marco Innamorati, Denise Erbuto, Gianluca Serafini, Andrea Fiorillo, Mario Amore, Paolo GirardiAbstract:Abstract Background Affective temperaments are associated with suicidal risk, but their predictive value relative to diagnosis of Major Affective Disorder is uncertain. Methods We compared diagnoses, Affective-temperament ratings (TEMPS-A), and other potential risk factors in 956 psychiatric inpatients, using bivariate analyses and multivariable logistic regression modeling for associations with suicidal status. Results Lifetime suicide-attempt rates were high (43.9% overall), ranking by diagnosis: bipolar-II (58.4%), Major depressive (50.0%), bipolar-I (44.6%), other (38.0%), and psychotic (33.9%) Disorders. TEMPS-A scores for depressive ( dep ), cyclothymic ( cyc ), irritable ( irr ), and anxious ( anx ) temperaments and their sum were strongly associated with suicidal risk; hyperthymic ( hyp ) temperament scores were inversely associated; and a composite measure ( dep+cyc+irr+anx – hyp ), even more strongly associated. The composite score was highly, independently associated with suicidal behavior ( p p =0.0002), but older age and diagnosis of Major Affective Disorder, much less (both p =0.02). Conclusions Measures of Affective temperament-types were independently and more strongly associated with lifetime suicide attempt than was diagnosis of a Major Affective Disorder. However, in this hospitalized cohort, suicide rates were high across diagnoses, possibly limiting the predictive value of diagnosis.
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decreased risk of suicides and attempts during long term lithium treatment a meta analytic review
Bipolar Disorders, 2006Co-Authors: Ross J Baldessarini, Leonardo Tondo, Paula Davis, Maurizio Pompili, Frederick K Goodwin, John HennenAbstract:Objectives: To update and extend comparisons of rates of suicides and suicide attempts among patients with Major Affective Disorders with versus without long-term lithium treatment. Methods: Broad searching yielded 45 studies providing rates of suicidal acts during lithium treatment, including 34 also providing rates without lithium treatment. We scored study quality, tested between-study variance, and examined suicidal rates on versus off lithium by meta-analytic methods to determine risk ratios (RRs) and 95% confidence intervals (CI). Results: In 31 studies suitable for meta-analysis, involving a total of 85,229 person-years of risk-exposure, the overall risk of suicides and attempts was five times less among lithium-treated subjects than among those not treated with lithium (RR = 4.91, 95% CI 3.82–6.31, p < 0.0001). Similar effects were found with other meta-analytic methods, as well as for completed versus attempted suicide, and for bipolar versus Major mood Disorder patients. Studies with higher quality ratings, including randomized, controlled trials, involved shorter exposures with somewhat lesser lithium superiority. Omitting one very large study or those involving lithium-discontinuation had little effect on the results. The incidence-ratio of attempts-to-suicides increased 2.5 times with lithium-treatment, indicating reduced lethality of suicidal acts. There was no indication of bias toward reporting positive findings, nor were outcomes significantly influenced by publication-year or study size. Conclusions: Risks of completed and attempted suicide were consistently lower, by approximately 80%, during treatment of bipolar and other Major Affective Disorder patients with lithium for an average of 18 months. These benefits were sustained in randomized as well as open clinical trials.
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two year syndromal and functional recovery in 219 cases of first episode Major Affective Disorder with psychotic features
American Journal of Psychiatry, 2000Co-Authors: Mauricio Tohen, Ross J Baldessarini, John Hennen, Carlos M Zarate, Stephen M Strakowski, Andrew L Stoll, Gianni L Faedda, Trisha Suppes, Priscilla Gebremedhin, Bruce M CohenAbstract:OBJECTIVE: Psychotic Affective Disorders are the most prevalent idiopathic psychoses, but their outcome from onset has rarely been studied. In this study, the authors determined the rate and latency of syndromal recovery and rates of functional recovery after first lifetime hospitalization in patients with first-episode psychotic Affective Disorders. METHOD: From first lifetime hospitalization in 1989–1996, 219 patients with a DSM-IV psychotic Affective illness were assessed at intervals over 24 months. Time to syndromal recovery (no longer meeting DSM-IV episode criteria) was assessed by survival analysis, and functional recovery (regaining baseline vocational and residential status) was rated. Factors associated with recovery were identified by bivariate and multivariate methods. RESULTS: By 3, 6, 12, and 24 months after first hospitalization, syndromal recovery was attained by 65.1%, 83.7%, 91.1%, and 97.5%, respectively, of subjects. Time to syndromal recovery (6.1 weeks to 50% of subjects recovered) ...
Tom G Bolwig - One of the best experts on this subject based on the ideXlab platform.
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on the increased risk of developing late onset epilepsy for patients with Major Affective Disorder
Journal of Affective Disorders, 2003Co-Authors: Flemming Morkeberg Nilsson, Lars Vedel Kessing, Tom G BolwigAbstract:Abstract Background: Based on register data we wanted to investigate whether patients with a diagnosis of Affective Disorder are at increased risk of developing epilepsy compared to other medically ill control groups. Methods: By linkage of public hospital registers covering the whole of Denmark from 1977 to 1993, using ICD-8 diagnoses, three study cohorts were identified: Patients with first Affective Disorder episodes (mania and depression), patients with first osteoarthritis and patients with first diabetes discharge. Time to first diagnosis of epilepsy was estimated with the use of survival analysis. Results: A total of 164,227 patients entered the study base: 13,748 patients with mania or depression, 81,380 patients with osteoarthritis and 69,149 patients with diabetes. The risk of getting a diagnosis of epilepsy was increased for patients with Affective Disorder compared with the risk for the control groups. However, the increased risk seemed to be due to the effect of comorbid alcohol or drug abuse and not to the effect of the Affective illness itself. Limitations: The results only apply to hospitalised patients. Diagnoses are not validated for research purposes. Conclusion: Patients with a diagnosis of Affective Disorder have an increased risk of developing epilepsy in later life. In patients with Affective Disorder, comorbid alcoholism/drug abuse seriously increased the risk of a subsequent diagnosis of epilepsy.
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increased risk of developing parkinson s disease for patients with Major Affective Disorder a register study
Acta Psychiatrica Scandinavica, 2001Co-Authors: Flemming Morkeberg Nilsson, Lars Vedel Kessing, Tom G BolwigAbstract:Objective: To investigate whether patients with a diagnosis of Affective Disorder are at an increased risk of developing Parkinson's disease compared with medically ill control groups. Method: By linkage of public hospital registers from 1977 to 1993, three study cohorts were identified: patients with Affective Disorder episodes (mania or depression) and patients with osteoarthritis or diabetes. Time to the first diagnosis of Parkinson's disease was estimated with the use of survival analysis. Results: A total of 164 385 patients entered the study base. The risk of being given a diagnosis of Parkinson's disease was significantly increased for patients with Affective Disorder, odds ratio 2.2 (CI 95% 1.7–2.8) compared with osteoarthritis, and depressive Disorders, odds ratio 2.2 (CI 95% 1.7–2.9) compared with osteoarthritis. Conclusion: This study supports the hypothesis of a common aetiology for Major Affective Disorder and Parkinson's disease.
