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Background: Subthreshold hypomania is defined as a distinct period of elevated, expansive or irritable mood lasting for at least four days, but insufficient to fulfill the criteria of hypomania. This study aimed to investigate the association between suicidality and subthreshold hypomania in subjects with and without major depressive disorder (MDD).Methods: Face-to-face interviews were completed for 12,526 adults, randomly selected through a one-person-per-household method, using the Korean version of the Composite International Diagnostic Interview (K-CIDI) and a questionnaire relative to lifetime suicide attempts (LSA).Results: Of the 12,526 participants, 11,701 did not have MDD, and 825 were diagnosed with MDD. The MDD with subthreshold hypomania group (n = 72) revealed significantly higher rates of LSA and post-traumatic stress disorder (PTSD) than those without (n = 753). Compared to the no MDD without subthreshold hypomania group (n = 11,571), the no MDD with subthreshold hypomania group (n = 130) showed a significantly higher prevalence of suicidality and comorbid conditions. In multivariate logistic regression analyses of depressive symptoms, subthreshold hypomania was significantly associated with morning worsening of mood. The MDD with subthreshold hypomania group was significantly associated with LSA (AOR=16.82, 95% CI 9.81-28.83, p< 0.001), compared to the no MDD group without subthreshold hypomania. Compared to the MDD without subthreshold hypomania group, the MDD with subthreshold hypomania group revealed a significant association with LSA (AOR=2.08, 95% CI 1.20-3.62, p< 0.001).Conclusions: A history of subthreshold hypomania doubled the risk of LSA in patients with MDD compared to those without subthreshold hypomania. [ABSTRACT FROM AUTHOR]

Background: Alcohol-induced disinhibition (AID) is defined as a "loss of restraint over some form of behavior after drinking alcohol regardless of its amount". Although many previous studies have investigated on alcohol use disorder and suicide attempt, few studies have focused on AID and suicide.Methods: A total of 9461 adults who had a history of drinking completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) with the Suicide Module, and Barratt Impulsiveness Scale 11 (BIS-11). In this study, we defined the AID group as those who had been involved with the two antisocial behaviors, including fights, being arrested or dangerous driving, according to the K-CIDI.Results: Among 9461 subjects, 564 were classified as the AID group (5.96%). The AID group had a significantly higher number of lifetime suicidal ideation, plan, attempt, and multiple attempts, and higher BIS-11 scores than non-AID group. The total scores of BIS-11 of the AID group reported the highest score compared with other psychiatric disorders. The AID group experienced more frequently three types of alcohol withdrawal symptoms, including nervousness, heart beating fast, and feeling weak. Compared with subjects without both AID and MDD, subjects with both AID and MDD showed significant association with a lifetime suicide attempt (AOR = 6.86, p < 0.001) and showed stronger association with multiple attempts (AOR = 10.38, p < 0.001).Conclusion: AID was associated with suicide attempt and impulsivity, and the both AID and MDD showed much stronger association with lifetime suicide attempt and multiple attempts. [ABSTRACT FROM AUTHOR]

Highlights • An anxiety attack means "a sudden attack of fear or intense anxiety". • Many people experienced anxiety attacks even without life-threatening situations. • Anxiety attacks were relevant to an increased suicide risk, especially without life-threatening situations and with comorbid MDD. Abstract Regardless of categorical diagnosis, many psychiatric patients suffer from sudden attack of fear or intense anxiety. In this study, we defined anxiety attacks to refer to these phenomena and investigated their association with depression and suicide attempts. A total of 12,532 adults randomly selected population through the one-person-per-household method completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI). A total of 5.88% reported to have experienced anxiety attacks. Among them, 46.5% reported to have experienced anxiety attacks without life-threatening situations. 'Anxiety attacks' group reported more suicidal ideation, plan, and attempts, which were even higher frequencies in 'anxiety attacks without life-threatening situations' group than 'anxiety attacks only with life-threatening situations' group and showed stronger association with lifetime suicide attempts when it had comorbid major depressive disorder (MDD) (AOR = 9.69, 95%CI 5.90–15.90), compared with 'never' group. There was no association between each symptom of patients with anxiety attacks and their lifetime suicide attempt. In conclusion, the finding suggests that there are as many individuals who experience anxiety attacks without life-threatening situations as those with life-threatening situations. And anxiety attacks appear to be relevant to an increased risk of suicide attempt, especially without life-threatening situations and with comorbid MDD. [ABSTRACT FROM AUTHOR]

Background: Suicide survivors are defined as victims who experienced suicide of siblings or parents, spouses, or lineal relatives within the fourth degree who had lived with them. We compared the effects of major depressive disorder (MDD), symptoms of posttraumatic stress disorder (PTSD), and impulsivity on lifetime suicide attempts among suicide survivors.Methods: Participants included 272 suicide survivors. We compared them to 5,200 members from the general population who were matched by age, sex, and years of education. We evaluated participants using the Patient Health Questionnaire-9 (PHQ-9), the EuroQuality of Life (EuroQol) scale, the Impact of Events Scale-Revised (IES-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Composite International Diagnostic Interview (K-CIDI).Results: Among the 272 suicide survivors, MDD was nine times higher (47.1% vs. 5.3%), and suicidal attempts were six times higher (20.5% vs. 3.3%) than reported among the general population. The suicide survivors showed more severe depression, greater impulsivity, and poorer quality of life than did the general population. In multivariate logistic regression analyses performed to evaluate each IES-R item, "trouble staying asleep" was the only PTSD symptom item that was significantly associated with suicide attempts among suicide survivors. Suicide survivors who had both MDD with insomnia and high impulsivity were at four times higher risk for suicide attempts than the general population with no MDD (AOR = 4.04, 95% CI: 1.25-13.09).Conclusions: Surviving suicide by family members is an important risk factor for suicide attempts. In particular, MDD with insomnia and impulsivity are associated with suicide attempts among suicide survivors. [ABSTRACT FROM AUTHOR]