INQ-15 cut-off scores for suicidal ideation screening of women with chronic, invisible illnesses.

In the interpersonal theory of suicide, perceived burdensomeness (PB) and thwarted belongingness (TB) are proximal triggers of suicidal ideation. Using the 15-item version of the Interpersonal Needs Questionnaire (INQ-15), suicidal ideation in psychiatric inpatients was predicted by the PB and TB scales, and cut-off scores were recommended. In this study, women (N = 942) who reported one or more chronic, invisible illnesses completed an online survey including the INQ-15 and the Suicide Behaviours Questionnaire-Revised (SBQ-R). PB and TB correlated significantly with SBQ-R total scores (r = 0.575 and 0.437, respectively; p < 0.01). In a Receiver Operating Characteristic analysis, scores of 17 for PB and 37 for TB maximized the correct classification of high-risk and low-risk participants, with slightly higher classification accuracy for PB than TB (AUCs = 0.781 and 0.701, respectively). These results support the INQ-15 scales in screening for suicidal ideation among chronically ill women.

Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome.

OBJECTIVE: We investigated the prevalence of suicidal ideation in relationship with symptoms of sleep disruption in people with postural orthostatic tachycardia syndrome (POTS). METHODS: Online surveys (including the Pittsburgh Sleep Quality Index and the Suicide Behaviors Questionnaire - Revised) were completed by 705 POTS patients and 170 non-POTS controls. RESULTS: Poor sleep quality was reported in 98.4% of POTS patients with a calculated subjective sleep efficiency of 65.4%. The POTS group's sleep efficiency was significantly lower (t[873]= -11.32; p<0.001) and sleep disturbances because of pain were significantly higher (t[873]=15.36; p<0.001) than controls. Chi-square testing showed a larger proportion of individuals at high-risk for suicide among POTS patients than controls (c2 [1, n=875]=55.6; p<0.001). Multiple linear regression analysis showed that sleep scores (ß=0.23, p<0.001), age (ß=-0.03, p<0.001), and illness with POTS (ß=0.68, p=0.05) were significantly associated with suicide ideation scores (F[4, 870]=38.34, p<0.001). This model explained 15% of variance (R2=0.15) in suicidal ideation scores. CONCLUSION: Patients with POTS may suffer from increased sleep disturbance and suicidal ideation compared with the general population. Treatment to improve sleep efficiency and sleep quality is an important step toward better quality of life for POTS patients.

Health-related quality of life and suicide risk in postural tachycardia syndrome.

PURPOSE: Postural tachycardia syndrome (POTS) is a disorder featured by orthostatic intolerance. The purpose of this study was to investigate the severity of quality of life issues in POTS patients. METHODS: Online surveys for health related quality of life, sleep quality, fatigue, pain, and suicidal ideation were completed by 624 POTS patients and 139 controls. RESULTS: People with POTS have significantly more days of poor physical health (p < 0.001), fewer days with good energy (p < 0.001), and significantly more days with activity limitations (p < 0.001) than controls. Pain severity was significantly higher for those with POTS (p < 0.001) while feelings of control over life was lower than controls (p < 0.001). Sleep quality and daytime fatigue were also significantly worse for those with POTS than controls (p < 0.001). Finally, those with POTS have a significantly higher risk of suicide compared with controls (p < 0.001). INTERPRETATION: The myriad of symptoms from which many POTS patients suffer is associated with a decreased quality of life. Nearly half of our sample with POTS was at high risk for suicide. More work needs to be done to determine the underlying issues surrounding suicide in POTS so that an appropriate treatment regimen can be developed.

Acute effects of cocaine on movement-related firing of dorsolateral striatal neurons depend on predrug firing rate and dose.

To investigate striatal mechanisms underlying the acute effects of stimulants on motor behavior, firing rates (FRs) of striatal neurons related specifically to vertical head movement were studied exclusively during vertical head movements. Precocaine FRs were recorded after intraperitoneal saline injection (time 1; T1), and rats performed conditioned vertical head movements (>10,000) similar to those induced by stimulants. After cocaine injection (0, 5, 10, or 20 mg/kg; T2), animals continued in the task. The proportion of long head movements was increased by low doses but decreased by the high dose, which induced stereotypic head movements. Comparing each neuron's FR during movements that were matched between T1 and T2 (e.g., regarding direction, distance), cocaine's effects depended on predrug FR and dose. Plots regressing T2FR on T1FR showed dose-dependent, "clockwise" rotations of regression lines in plots of all the neurons' average FRs and of individual neurons' FRs during different movements. All three doses elevated normally low FRs; the high dose also suppressed many higher FRs. Enhancement of a neuron's FR associated with weak and suppression of FR associated with strong corticostriatal inputs contradict several current theories of dopamine (DA) function. Induction of stereotypy by a single, high-dose injection suggests that this cocaine level exceeded that in other studies using cocaine self-administration, in which stereotypy develops only after several sessions. Suppressive effects observed only at the high dose and in numerous electrophysiological studies of DA agonist effects may be unrepresentative of uniform elevations in lateral striatal firing related to movement observed at lower cocaine levels.

Childhood emotional neglect related to posttraumatic stress disorder symptoms and body mass index in adult women.

The relationships among the severity of childhood abuse and neglect, posttraumatic stress disorder (PTSD), and adult obesity were investigated. 207 women (M age = 26.5 yr., SD = 6.7) completed the Childhood Trauma Questionnaire, Millon Clinician Multiaxial Inventory, and a demographic questionnaire. Analyses of variance indicated that women who reported moderate-to-extreme emotional neglect (n = 71) had significantly higher PTSD scores and increased BMI compared to women who reported low emotional neglect (n = 84). Women who reported severe sexual or emotional abuse also had higher PTSD scores, but no relationship was found with BMI when other factors were controlled. Although PTSD scores and self-reported severity of childhood emotional neglect were strongly correlated (r = .61, p < .001), PTSD was not found to be a mediating factor in obesity in women who reported childhood emotional neglect, although depression was.

Childhood abuse related to nicotine, illicit and prescription drug use by women: pilot study.

A sample of 811 women ages 18 to 59 (M=26.0, SD=6.5) responded to an advertisement by telephone. Inquiries were made about childhood abuse status and adult use of alcohol, nicotine, and prescription and illicit drugs. Significant associations were noted for reported sexual, physical, and emotional childhood abuse with use of nicotine, marijuana, and antidepressants in adulthood. Reported childhood physical and emotional abuses were also significantly associated with use of cocaine and anxiolytics, and sexual abuse with antipsychotic use in adulthood. Only childhood emotional abuse was associated with the use of sleeping pills. Number of types of abuse was significantly related with use of nicotine, marijuana, cocaine, antidepressants, antipsychotics, and anxiolytics. Alcohol use was not related to any type of abuse. The long-term effects of childhood emotional abuse may be just as severe as physical or sexual abuse.

Hippocampal volume and memory performance in a community-based sample of women with posttraumatic stress disorder secondary to child abuse.

Childhood abuse is linked to posttraumatic stress disorder (PTSD), which follows abuse survivors into adulthood. This study identified the neuropsychological and neuromorphological sequelae of PTSD among prepubescently abused women. Right-handed women aged 20-40 years were placed into PTSD and abuse, abuse only, and normal control groups (n = 17 per group). Participants were screened for trauma history and psychiatric symptoms, demographically matched, and given neuropsychological tests and a magnetic resonance scan of their brain. Women with PTSD did not express significant deficits in memory performance or hippocampal volume when compared with the abuse and normal control groups.