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Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients
Suicidal behavior is often conceptualized as a response to overwhelming stress. Our model posits that given a propensity for acting on suicidal urges, stressors such as life events or major depressive episodes (MDEs) determine the timing of suicidal acts. Depressed patients (n=415) were assessed pro...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988274/ https://www.ncbi.nlm.nih.gov/pubmed/24126928 http://dx.doi.org/10.1038/mp.2013.128 |
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author | Oquendo, Maria A. Perez-Rodriguez, M. Mercedes Poh, Ernest Sullivan, Gregory Burke, Ainsley K. Sublette, M. Elizabeth Mann, J. John Galfalvy, Hanga |
author_facet | Oquendo, Maria A. Perez-Rodriguez, M. Mercedes Poh, Ernest Sullivan, Gregory Burke, Ainsley K. Sublette, M. Elizabeth Mann, J. John Galfalvy, Hanga |
author_sort | Oquendo, Maria A. |
collection | PubMed |
description | Suicidal behavior is often conceptualized as a response to overwhelming stress. Our model posits that given a propensity for acting on suicidal urges, stressors such as life events or major depressive episodes (MDEs) determine the timing of suicidal acts. Depressed patients (n=415) were assessed prospectively for suicide attempts and suicide, life events and MDE over 2 years. Longitudinal data was divided into 1-month intervals characterized by MDE (yes/no), suicidal behavior (yes/no), and life event scores. Marginal logistic regression models were fit, with suicidal behavior as the response variable and MDE and life event score in either the same or previous month, respectively, as time-varying covariates. Among 7843 person-months, 33% had MDE and 73% had life events. MDE increased risk for suicidal behavior (OR=4.83, p< 0.0001). Life event scores were unrelated to the timing of suicidal behavior (OR=1.06 per 100 point increase, p=0.32), even during an MDE (OR=1.12, p=0.15). However, among those without Borderline Personality Disorders (BPD), both health and work related life events were key precipitants, as was recurrent MDE, with a 13-fold effect. The relationship of life events to suicidal behavior among those with BPD was more complex. Recurrent MDE was a robust precipitant for suicidal behavior, regardless of BPD comorbidity. The specific nature of life events is key to understanding the timing of suicidal behavior. Given unanticipated results regarding the role of BPD and study limitations, these findings require replication. Of note, that MDE, a treatable risk factor, strongly predicts suicidal behaviors is cause for hope. |
format | Online Article Text |
id | pubmed-3988274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
record_format | MEDLINE/PubMed |
spelling | pubmed-39882742015-02-01 Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients Oquendo, Maria A. Perez-Rodriguez, M. Mercedes Poh, Ernest Sullivan, Gregory Burke, Ainsley K. Sublette, M. Elizabeth Mann, J. John Galfalvy, Hanga Mol Psychiatry Article Suicidal behavior is often conceptualized as a response to overwhelming stress. Our model posits that given a propensity for acting on suicidal urges, stressors such as life events or major depressive episodes (MDEs) determine the timing of suicidal acts. Depressed patients (n=415) were assessed prospectively for suicide attempts and suicide, life events and MDE over 2 years. Longitudinal data was divided into 1-month intervals characterized by MDE (yes/no), suicidal behavior (yes/no), and life event scores. Marginal logistic regression models were fit, with suicidal behavior as the response variable and MDE and life event score in either the same or previous month, respectively, as time-varying covariates. Among 7843 person-months, 33% had MDE and 73% had life events. MDE increased risk for suicidal behavior (OR=4.83, p< 0.0001). Life event scores were unrelated to the timing of suicidal behavior (OR=1.06 per 100 point increase, p=0.32), even during an MDE (OR=1.12, p=0.15). However, among those without Borderline Personality Disorders (BPD), both health and work related life events were key precipitants, as was recurrent MDE, with a 13-fold effect. The relationship of life events to suicidal behavior among those with BPD was more complex. Recurrent MDE was a robust precipitant for suicidal behavior, regardless of BPD comorbidity. The specific nature of life events is key to understanding the timing of suicidal behavior. Given unanticipated results regarding the role of BPD and study limitations, these findings require replication. Of note, that MDE, a treatable risk factor, strongly predicts suicidal behaviors is cause for hope. 2013-10-15 2014-08 /pmc/articles/PMC3988274/ /pubmed/24126928 http://dx.doi.org/10.1038/mp.2013.128 Text en Users may view, print, copy, download and text and data- mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Oquendo, Maria A. Perez-Rodriguez, M. Mercedes Poh, Ernest Sullivan, Gregory Burke, Ainsley K. Sublette, M. Elizabeth Mann, J. John Galfalvy, Hanga Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title | Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title_full | Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title_fullStr | Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title_full_unstemmed | Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title_short | Life Events: A Complex Role In The Timing Of Suicidal Behavior Among Depressed Patients |
title_sort | life events: a complex role in the timing of suicidal behavior among depressed patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988274/ https://www.ncbi.nlm.nih.gov/pubmed/24126928 http://dx.doi.org/10.1038/mp.2013.128 |
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