Main Article Content
Abstract
BACKGROUND
In this study, we wanted to evaluate the prevalence and association of impulsivity and psychiatric morbidity in suicide attempters, along with the socio-demographic characteristics of those who attempt suicide.
METHODS
This was a hospital-based cross-sectional analytical study conducted among 150 patients who presented with a history of suicide attempt to the Department of Psychiatry, Government Medical College, Kannur, Kerala, from 1st May 2021 to 30th April 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
RESULTS
Psychiatric morbidity was seen among 81% of the study participants, and the commonest among them were mood disorders (47%) including (major depression, bipolar, and dysthymia) followed by a general anxiety disorder, phobia, anxiety disorder NOS, obsessive-compulsive disorder, and stress-related disorder (14%). The overall scores were observed to be a mean (SD) of 62.3 (8.9), while the distribution of BIS “Non- Planning”, BIS “Motor Impulsiveness” and BIS “Attentional Impulsiveness” was observed to be 29.6 (7.1), 19.5 (4.9), and 13.1 (3.4) respectively. Also, it was seen that there was a statistically significant difference in the distribution of BIS scores in relation to the overall score, “Non- Planning”, and BIS “Motor Impulsiveness” between the proportion having psychiatric morbidity and without psychiatric morbidity (p-value <0.05).
CONCLUSIONS
We found that a history of suicide attempts was more common among males. The 4/5th of the participants had some form of psychiatric morbidity and the most common ones seen among the participants were major depression, bipolar, and dysthymia followed by anxiety disorder.
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References
- Beck AT, Beck R, Kovacs M. Classification of suicidal behaviors: I. Quantifying intent and medical lethality. Am J Psychiatry 1975;132(3):285-7.
- Alem A, Kebede D, Jacobsson L, et al. Suicide attempts among adults in Butajira, Ethiopia. Acta Psychiatr Scand 1999;100:70-6.
- Taylor SJ, Kingdom D, Jenkins R. How are nations trying to prevent suicide? An analysis of national suicide prevention strategies. Acta Psychiatr Scand 1997;95(6):457-63.
- Bonvoisin T, Utyasheva L, Knipe D, et al. Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends. BMC Public Health 2020;20(1):251.
- Nordstrom P, Samuelson M, Asberg M. Survival analysis of suicide. Br J Psychiatry 1998;173:531-5.
- Moeller FG, Barratt ES, Dougherty DM, et al. Psychiatric aspects of impulsivity. Am J Psychiatry 2001;158(11):1783- 93.
- Mann JJ, Arango VA, Avenevoli S, et al. Candidate endophenotypes for genetic studies of suicidal behavior. Biological Psychiatry 2009;65(7):556-63.
- Doihara C, Kawanishi C, Ohyama N, et al. Trait impulsivity in suicide attempters: preliminary study. Psychiatry Clin Neurosci 2012;66(6):529-32.
- Dougherty DM, Mathias CW, Marsh DM, et al. Laboratory measured behavioral impulsivity relates to suicide attempt history. Suicide Life‐Threat Behav 2004;34(4):374-85.
- Eysenck SB, Eysenck HJ. The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 1977;16(1):57-68.
- Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol 1995;51(6):768-74.
- Marinkovic K, Halgren E, Klopp J, et al. Alcohol effects on movement- related potentials: a measure of impulsivity? J Stud Alcohol 2000;61(1):24-31.
- Corruble E, Damy C, Guelfi JD. Impulsivity: a relevant dimension in depression regarding suicide attempts? J Affect Disord 1999;53(3):211-5.
- Nock MK, Deming CA, Chiu WT, et al. Mental disorders, comorbidity, and suicidal. Suicide: Global perspectives from the WHO World Mental Health Surveys. Cambridge University Press 2012:148-63.
- Baca-Garcia E, Vaquero C, Diaz-Sastre C, et al. Lack of association between the serotonin transporter promoter gene polymorphism and impulsivity or aggressive behavior among suicide attempters and healthy volunteers. Psychiatry Res 2004;126(2):99-106.
- Suominen KM, Henriksson M, Suokas J, et al. Mental disorders and comorbidity in attempted suicide. Acta Psychiatr Scand 1996;94(4):234-40.
- Oquendo MA, Waternaux C, Brodsky B, et al. Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. J Affect Disord 2000;59(2):107-17.
- Allebeck P, Varla A, Kristjansson E, et al. Risk factors for suicide among patients with schizophrenia. Acta Psychiatr Scand 1987;76(4):414-9.
- Pedinielli JL, Delahousse J, Chabaud B. The "lethality" of attempted suicide. Ann Med Psychol (Paris) 1989;147(5):535-50.
- Stanley B, Gameroff MJ, Michalsen V, et al. Are suicide attempters who self- mutilate a unique population? Am J Psychiatry 2001;158(3):427-32.
- Gómez A, Barreras A, Jaar E, et al. Sociodemographic and clinical characteristics of women who attempted suicide. Acta Psiquiatr Psicol Am Lat 1993;39(3):223-30.
- Costanza A, Rothen S, Achab S, et al. Impulsivity and impulsivity-related endophenotypes in suicidal patients with substance use disorders: an exploratory study. International Journal of Mental Health and Addiction 2021;19(5):1729-44.
- Alasaarela L, Hakko H, Riala K, et al. Association of self-reported impulsivity to nonsuicidal self-injury, suicidality, and mortality in adolescent psychiatric inpatients. The Journal of Nervous and Mental Disease 2017;205(5):340-5.
- Parks-Leduc L, Feldman G, Bardi A. Personality traits and personal values: a meta-analysis. Personality and Social Psychology Review 2015;19(1):3-29.
- Lakshmi KP, Chandra S. Impulsivity in suicide attempters: a cross-sectional study in a tertiary care centre in Kerala. International Journal of Scientific Research 2021;10(4).
- Knipe D, Williams AJ, Hannam-Swain S, et al. Psychiatric morbidity and suicidal behaviour in low-and middle- income countries: a systematic review and meta-analysis. PLoS Med 2019;16(10):e1002905.
References
Beck AT, Beck R, Kovacs M. Classification of suicidal behaviors: I. Quantifying intent and medical lethality. Am J Psychiatry 1975;132(3):285-7.
Alem A, Kebede D, Jacobsson L, et al. Suicide attempts among adults in Butajira, Ethiopia. Acta Psychiatr Scand 1999;100:70-6.
Taylor SJ, Kingdom D, Jenkins R. How are nations trying to prevent suicide? An analysis of national suicide prevention strategies. Acta Psychiatr Scand 1997;95(6):457-63.
Bonvoisin T, Utyasheva L, Knipe D, et al. Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends. BMC Public Health 2020;20(1):251.
Nordstrom P, Samuelson M, Asberg M. Survival analysis of suicide. Br J Psychiatry 1998;173:531-5.
Moeller FG, Barratt ES, Dougherty DM, et al. Psychiatric aspects of impulsivity. Am J Psychiatry 2001;158(11):1783- 93.
Mann JJ, Arango VA, Avenevoli S, et al. Candidate endophenotypes for genetic studies of suicidal behavior. Biological Psychiatry 2009;65(7):556-63.
Doihara C, Kawanishi C, Ohyama N, et al. Trait impulsivity in suicide attempters: preliminary study. Psychiatry Clin Neurosci 2012;66(6):529-32.
Dougherty DM, Mathias CW, Marsh DM, et al. Laboratory measured behavioral impulsivity relates to suicide attempt history. Suicide Life‐Threat Behav 2004;34(4):374-85.
Eysenck SB, Eysenck HJ. The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 1977;16(1):57-68.
Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol 1995;51(6):768-74.
Marinkovic K, Halgren E, Klopp J, et al. Alcohol effects on movement- related potentials: a measure of impulsivity? J Stud Alcohol 2000;61(1):24-31.
Corruble E, Damy C, Guelfi JD. Impulsivity: a relevant dimension in depression regarding suicide attempts? J Affect Disord 1999;53(3):211-5.
Nock MK, Deming CA, Chiu WT, et al. Mental disorders, comorbidity, and suicidal. Suicide: Global perspectives from the WHO World Mental Health Surveys. Cambridge University Press 2012:148-63.
Baca-Garcia E, Vaquero C, Diaz-Sastre C, et al. Lack of association between the serotonin transporter promoter gene polymorphism and impulsivity or aggressive behavior among suicide attempters and healthy volunteers. Psychiatry Res 2004;126(2):99-106.
Suominen KM, Henriksson M, Suokas J, et al. Mental disorders and comorbidity in attempted suicide. Acta Psychiatr Scand 1996;94(4):234-40.
Oquendo MA, Waternaux C, Brodsky B, et al. Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. J Affect Disord 2000;59(2):107-17.
Allebeck P, Varla A, Kristjansson E, et al. Risk factors for suicide among patients with schizophrenia. Acta Psychiatr Scand 1987;76(4):414-9.
Pedinielli JL, Delahousse J, Chabaud B. The "lethality" of attempted suicide. Ann Med Psychol (Paris) 1989;147(5):535-50.
Stanley B, Gameroff MJ, Michalsen V, et al. Are suicide attempters who self- mutilate a unique population? Am J Psychiatry 2001;158(3):427-32.
Gómez A, Barreras A, Jaar E, et al. Sociodemographic and clinical characteristics of women who attempted suicide. Acta Psiquiatr Psicol Am Lat 1993;39(3):223-30.
Costanza A, Rothen S, Achab S, et al. Impulsivity and impulsivity-related endophenotypes in suicidal patients with substance use disorders: an exploratory study. International Journal of Mental Health and Addiction 2021;19(5):1729-44.
Alasaarela L, Hakko H, Riala K, et al. Association of self-reported impulsivity to nonsuicidal self-injury, suicidality, and mortality in adolescent psychiatric inpatients. The Journal of Nervous and Mental Disease 2017;205(5):340-5.
Parks-Leduc L, Feldman G, Bardi A. Personality traits and personal values: a meta-analysis. Personality and Social Psychology Review 2015;19(1):3-29.
Lakshmi KP, Chandra S. Impulsivity in suicide attempters: a cross-sectional study in a tertiary care centre in Kerala. International Journal of Scientific Research 2021;10(4).
Knipe D, Williams AJ, Hannam-Swain S, et al. Psychiatric morbidity and suicidal behaviour in low-and middle- income countries: a systematic review and meta-analysis. PLoS Med 2019;16(10):e1002905.