Chronobiological alterations tied to passive, active suicidal ideation and preparation
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Chronobiological alterations appeared directly linked to passive and active suicidal ideation and preparation, according to study results published in Journal of Clinical Psychiatry.
Specifically, dysrhythmicity of sleep, activities and social life played a key role in this association.
“We still need to study predictors of suicidal risk in mood disorders, since patients with mood disorders have high mortality rates for suicide,” Laura Palagini, MD, PhD, of the department of clinical and experimental medicine at the University of Pisa in Italy, told Healio Psychiatry. “This is the first time the role of chronobiological dysrhythmicity has been explored in relation to suicidal ideation and behaviors in bipolar disorder. In addition, for the first time we have explored the potential association among alterations in circadian rhythms and one of the strongest predictors of suicidal risk, which is hopelessness.”
Palagini and colleagues recruited 127 individuals with a major depressive episode and bipolar disorder type 1 or 2 according to Structured Clinical Interview for DSM-5 assessment. They assessed participants for depressive and manic symptoms according to the Beck Depression Inventory-II and the Young Mania Rating Scale, as well as with the Biological Rhythms Interview of Assessment in Neuropsychiatry, Beck Hopelessness Scale and Scale for Suicide Ideation. Further, they performed univariate regression and mediation analyses.
Results showed clinically significant suicidal ideation among 41 (32.3%) participants, who were more frequently affected by bipolar disorder type 1 with mixed features. These individuals had significantly more depressive symptoms, higher emotional component of hopelessness and higher dysrhythmicity of sleep, activities and social life vs. nonsuicidal individuals. Dysrhythmicity of sleep and social life best predicted passive and active suicidal ideation and suicidal plans. The researchers noted dysrhythmicity of sleep and social life mediated the direct effect of depressive symptoms on active and passive suicidal ideation, as well as of active ideation on suicidal plans. Further, they observed an association between the emotional component of hopelessness and dysrhythmicity of social life, and that this association mediated its effect on suicidal plans.
“These findings call for the systematic screening of these dysrhythmicity dimensions when considering suicidal risk in individuals with bipolar disorder, in particular by assessing and targeting alterations in chronobiological rhythms of sleep and social life in bipolar disorders with chronotherapeutics, such as melatonin supplementation or light/dark therapy, which may prevent suicidal plans,” Palagini said.