Suicide risk increased by sleep disorder presence

This article discusses the association seen between presence of a sleep disorder in older adults and increased suicide risk.

Sleep quality influences suicide risks for older adults, according to a research undertaken by scientists from Stanford University School of Medicine. Rebecca Bernert, the study’s author, says this is a highly treatable condition. Bernert, PhD, is the director of the Suicide Prevention Research Laboratory at Stanford. The fact that sleep disorder increases suicide risks for older adults comes after a complex research.

Another research carried earlier this year involvedblood analysis to determine suicide risks.

“Suicide is the outcome of multiple, often interacting biological, psychological and social risk factors,” Bernert said. “Disturbed sleep stands apart as a risk factor and warning sign in that it may be undone, which highlights its importance as a screening tool and potential treatment target in suicide prevention.

To reach the conclusion, the team of scientists from Stanford looked at data from 14.456 adults over 65 years old. Out of this group, they chose 400 individuals who had similar sleeping patterns to 20 people who committed suicide. Scientists followed the sleeping behavior over a 10 years period. In the end, researchers concluded that older people with sleeping disorders have a suicide risk 1.4 times higher than their counterparts with high sleep quality.

The comparison between the two groups was done by looking at a series of data obtained through interviews. The questions addressed topics such as depression signs, and mental and physical functioning. Even after taking out the depression variable, the lack of quality sleep remained an important factor determining an increased risk of committing suicide.

Suicide is associated with stigma, so people suffering suicidal thoughts or attempts have troubles talking about the issue. However, if a disturbed sleeping pattern accounts for such a high influence in determining suicide, there is a ray of hope. If trouble sleeping is not a stigmatized disorder, focusing on improving the older adults’ sleep quality might reduce the suicide rates.

The subjects involved in the study were mostly white males. A group of twenty suicide victims is surely not enough to draw the definitive conclusion that sleep disorder increases suicide risks, but is a start. Further research involving data from cases involving women and minority groups may shed additional light on the issue.

People who are at risk of committing suicide should ask for help by calling the National Suicide Prevention Lifeline (1-800-273-TALK).

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Those with Asperger syndrome are more likely to commit suicide

A study shows that those with Asperger syndrome have a higher risk of suicide. This is especially true if they are depressed.

Adults with the milder form of autism known as Asperger syndrome are much more likely to think about and attempt suicide than those in the general population, a new British study suggests.

The survey of 374 British adults with Asperger syndrome found that 66 percent reported having suicidal thoughts and 35 percent had planned or attempted suicide. Suicidal thoughts were much more common among those with a history of depression, the authors noted.

In comparison, rates of suicidal thoughts were 17 percent in the general population of U.K. adults and 59 percent of patients with psychosis, according to the study published June 24 in The Lancet Psychiatry.

Among adults with Asperger syndrome, those with depression were four times more likely to have suicidal thoughts and twice as likely to plan or attempt suicide, compared to those without depression, the investigators found.

The study also found that adults with more severe autism symptoms were more likely to plan or attempt suicide.

"Our findings confirm anecdotal reports that adults with Asperger syndrome have a significantly higher risk of suicide in comparison to other clinical groups, and that depression is a key risk factor in this," study co-leader Dr. Sarah Cassidy, of the Autism Research Centre at Cambridge University, said in a journal news release.

And, study co-leader Simon Baron-Cohen, also of Cambridge, added, "Adults with Asperger syndrome often suffer with secondary depression due to social isolation, loneliness, social exclusion, lack of community services, under-achievement and unemployment."

However, Baron-Cohen believes that "their depression and risk of suicide are preventable with the appropriate support. This study should be a wake-up call for the urgent need for high-quality services, to prevent the tragic waste of even a single life," he said in the news release.

Two experts in the United States weren't surprised by the findings.

Dr. Melissa Nishawala is assistant professor at the Child Study Center at NYU Langone Medical Center in New York City. She said the new study supports "something we have known clinically for quite some time: bright, verbal individuals with autism spectrum disorder (ASD), commonly described as Asperger syndrome, have a much higher rate of depression, suicidal ideation and suicide attempts than peers who are not on the autism spectrum."

Nishawala agreed with Baron-Cohen that the finding "underscores the unmet need for increased support and resources for people with ASD at each developmental stage from childhood through adulthood."

Dr. Alexander Kolevzon, clinical director of the Seaver Autism Research Center at Mount Sinai Hospital, agreed. He said the study "will likely have an impact on patient care by raising clinical suspicion for suicidality [in patients with Asperger syndrome] and highlighting the need for treatment and close monitoring."

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Study shows that ADHD treatment does not increase suicide risk

A study shows that drug therapy for ADHD does not increase suicide risk.

A new register-based study from Karolinska Institutet in Sweden shows that drug therapy for ADHD does not entail an increased risk of suicide attempts or suicide, as was previously feared. The results are published in the British Medical Journal (BMJ).

"Our work in several ways shows that most likely there is no link between treatment with ADHD drugs and an increased risk of suicide attempts or suicide. The results rather indicate that ADHD drugs may have a protective effect," says Henrik Larsson, researcher at the Department of Medical Epidemiology and Biostatistics, who headed the study.

Earlier research has indicated that ADHD drug treatment would increase the occurrence of suicidal thoughts. However, these studies have been small scale and/or the methods used have been limited, which make the results uncertain. To gain clarity in this matter, researchers at Karolinska Institutet have now used national patient registers to identify all patients in Sweden diagnosed with ADHD between 1960 and 1996; a total of 37,936 individuals. These people were then followed over the period 2006-2009, in terms of drug treatment and events that could be linked to suicide attempts and suicide.

Among other things, the study compared the rate of suicidal behaviors while the patients were receiving ADHD medication, as compared with the rate for the same patients while not receiving medication. Using this design the researchers were able to determine that there was no evidence to support that ADHD drug therapy would increase the risk of suicide attempts/suicide. One strong point of the study now being published is that all the individuals were compared to themselves, as this allowed the researchers to take into account the differences between those taking the drugs and those who do not.

"Many epidemiological studies on the risks related to drugs fail to adjust for the differences between individuals who take the drugs and those who do not. This is a critical limitation given that the individuals on medication are usually more severely ill than the others," says Henrik Larsson.

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Autism in adults leads to many health problems

This article discusses how autism in adults can result in many other health problems.

Autism apparently isn't a stand-alone disorder, with new research revealing that adults with autism often face a host of mental and physical illnesses.

Kaiser Permanente researchers found that nearly all medical conditions are significantly more common in adults with autism spectrum disorders than those without, ranging from depression to gastrointestinal problems to obesity. Notably, however, adults with autism are much less likely to smoke or use alcohol than other adults, and cancer rates are similar.

"Some of these conditions we've seen in children with autism, so we expected higher rates of anxiety and depression, and some of the medical disorders, such as gastrointestinal disturbances, in adults," said study author Lisa Croen, director of the Kaiser Permanente Autism Research Program in Oakland, Calif.

"That's been reported for a long time in children, so we're not surprised to see those continue to be elevated," she added. "But we were surprised by the magnitude of what we found."

The study is scheduled to be presented Thursday at the International Meeting for Autism Research in Atlanta. Research presented at scientific conferences typically has not been peer-reviewed or published and results are considered preliminary.

Diagnosed in about 1 in 68 American children, autism spectrum disorder is the fastest-growing serious developmental disability in the United States, according to the advocacy and research organization Autism Speaks.

The disorder can be mild or severe, but symptoms typically include social and communication difficulties and repetitive behaviors.

Croen and her colleagues examined medical records from 2008 to 2012, and compared the prevalence of psychiatric, behavioral and medical diagnoses among 2,100 adults with an autism spectrum disorder to 21,000 adults without the disorder.

Adults diagnosed with an autism spectrum disorder had markedly higher rates of mental health problems than the other adults:

• Depression (38 percent versus 17 percent)
• Anxiety (39 percent versus 18 percent)
• Bipolar disorder (30 percent versus 9 percent)
• Suicide attempts (1.6 percent versus 0.3 percent)

People with autism spectrum disorders were also more likely than adults without the disorder to have physical ailments, such as:

• Diabetes (6 percent versus 4 percent)
• Gastrointestinal disorders (47 percent versus 38 percent)
• Epilepsy (12 percent versus 1 percent)
• Sleep disorders (19 percent versus 10 percent)
• High cholesterol (26 percent versus 18 percent)
• High blood pressure (27 percent versus 19 percent)
• Obesity (27 percent versus 16 percent)

"What the data show is really an extension of what we've learned already of children and adolescents with autism," said Dr. Paul Wang, senior vice president and head of medical research for Autism Speaks, who wasn't involved in the study. "It's not just a brain disorder -- it's really a disorder that affects the whole body. And this shows that these problems don't go away."

Croen said that many possible reasons exist for the wide gap in mental and physical ailments suffered by adults with autism, including a potential genetic basis. But the "core impairments" of those with autism -- such as communication problems and heightened sensitivity to touch -- can also make it difficult for them to be properly examined by clinicians, she said.

"People with autism often have very selective eating and their nutrition suffers," Croen added. "Their social impairments can lead to isolation, which leads to a lack of exercise. So some lifestyle factors can create more unhealthy lifestyles."

Social isolation may also explain why adults with autism are less likely to drink alcohol or smoke, noted Croen, also a senior research scientist at Kaiser Permanente Northern California Division of Research.

"Smoking and drinking are more social behaviors, especially in young people," she said. "Or, that's how it gets started. These young people with autism are out of the mainstream."

Croen and Wang agreed that autism researchers should extend their focus beyond the brain to multiple bodily systems as well as examine the transition from pediatric to adult health care.

"I hope these findings raise awareness among the medical community and others that adults with autism have a really high burden of medical and psychiatric conditions, much more than people think," Croen said. "There's a real need for doctors to be educated about autism and the characteristics of these adults so they can provide adequate and effective care."

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Study: Asthma and migraine linked admission of self-harm

A study claims that there is a link between having asthma and migraine and a person admitting to self-harm.

Certain long-term physical disorders, such as asthma and migraine, may boost the risk of self- harm, indicates a comparative study of hospital admissions after an episode of deliberate injury in England, and published in the Journal of the Royal Society of Medicine.

Over 200,000 people are admitted to hospital every year in England as a result of self-harm, and people who self-harm have a substantially increased risk of suicide.

The new National Suicide Prevention Strategy for England includes several priority groups including people with a history of self-harm, young people, and those living with long-term physical health conditions.

The peak age for self-harm is 15–24 years, and suicide is the third leading cause of death in this age group.

While it’s well known that psychiatric illness greatly increases the risk of self-harm, it’s less clear whether physical disorders have a similar impact.

The researchers therefore looked at risk of hospital admission for self-harm among people with different long-term psychiatric and physical disorders across England, using a linked dataset of Hospital Episode Statistics (HES) for 1999–2011.

The psychiatric illnesses studied included depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse.

Unsurprisingly, the analysis showed that patients with these conditions were at much greater risk. They were more than five times as likely to self-harm as those without these conditions, the findings showed.

But certain physical ailments also seemed to be linked to an increased risk of self-harm. Among the physical illnesses studied, patients with epilepsy were around three times more likely to self-harm, while those with asthma or migraine were almost twice as likely to do so.

Patients with psoriasis and diabetes also had a moderately increased risk of self-harm of around 60%, while those with eczema and inflammatory polyarthropathies were around 40% more likely to do so.

Patients with cancers under the age of 65, congenital heart disease, ulcerative colitis, sickle cell anaemia and Down’s syndrome were less likely to self-harm.

“It is important for physicians, general practitioners and mental health workers to be aware of the physical disorders that are associated with an increased risk of self-harm so that at-risk individuals may be better identified and can be monitored for any psychiatric symptoms and mental distress,” write the authors.

Much greater integration of medical and mental health services is needed, they say.

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Study: Migraine sufferers are twice as likely to also have depression

A study claims that depression is twice as likely in people who suffer from migraines in comparison to those who do not.

People who suffer from migraines are about twice as likely to be depressed and have suicidal thoughts, according to Canadian researchers, who say women and young people with migraines are particularly vulnerable to what Winston Churchill has called “the black dog” of depression.

Researchers at the University of Toronto surveyed more than 67,000 Canadians, over 6,000 of those reporting they had been diagnosed with migraine by a health care professional.

Both women and men with migraine were more than twice as likely to suffer from depression as those without the disease (women: 12.4% vs. 5.7%; men: 8.4% vs. 3.4%).

Serious thoughts of suicide – also known as suicide ideation – were also more common for migraine sufferers (women: 17.6% versus 9.1%; men: 15.6% versus 7.9%). Migraine sufferers under the age of 30 had four times the odds of suicidal ideation than those 65 and over.

Previous studies have also shown a link between migraines, suicide and depression, but this is one of the first to dig deeper and look at other factors associated with the comorbidities.  The study is published online in the journalDepression Research and Treatment.

Among both women and men with migraine, being younger, unmarried, poor, or disabled increased the odds of depression – in some cases dramatically. Single people with migraine were found to have 50% and 70% higher odds of depression and suicidal thoughts.

“The vulnerability of young people with migraine to depression and suicidal ideation is particularly worrying. For both genders, migraineurs under the age of 30 had at least six times the odds of current depression and four times the odds of lifetime suicidal ideation when compared to those aged 65 and above,” wrote lead author Esme Fuller-Thomson, a professor in the Department of Family & Community Medicine, University of Toronto.

“Older migraineurs, by contrast, have had a longer time to adjust to their condition, for example, by learning effective coping mechanisms or achieving adequate treatment, which may reduce the perceived burden of their illness.”

The first onset of migraine is typically experienced in late adolescence and early adulthood. The researchers believe diagnosis of migraine at a young age may interfere with normal developmental processes, such as obtaining an education, building a career, and starting a family.

“We are not sure why younger migraineurs have such a high likelihood of depression and suicidal ideation. It may be that younger people with migraines have not yet managed to find adequate treatment or develop coping mechanisms to minimize pain and the impact of this chronic illness on the rest of their lives,” said study co-author and former graduate student Meghan Schrumm.

The researchers say health care providers treating patients with migraine should be alert to signs of depression, particularly if the patient is younger and single.

“Informing a wider range of health professionals and migraine sufferers themselves about the patterns of depression and suicidal ideation surrounding age, marital status, and activity limitations may help to increase awareness of the comorbidities of migraine and empower migraineurs to come forward with their mental health concerns,” said Fuller-Thomson.

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Study: Epilepsy indicates a person is 11 times more likely to die prematurely

A study from the UK claims that a person with epilepsy is 11 times more likely to die prematurely than a person without epilepsy. A person with epilepsy is also more likely to commit suicide than a person without epilepsy.

Nine per cent of people with epilepsy died young compared with just 0.7 per cent of those without the condition, the 41-year research discovered.

And the findings, published in The Lancet, showed that people with both epilepsy and alcohol or drug disorders were 22 times more likely to die than someone who did not have either.

Someone who has epilepsy is also four times more likely to commit suicide than someone who does not, the team from Oxford University said.

Only half of the UK’s 600,000 epilepsy sufferers are seizure-free, and one in 20 people will have an epileptic seizure at some point in their life.

Dr Seena Fazel from Oxford University, who led the study, said standard checks could help reduce the risk of premature deaths in people with epilepsy.

Dr Fazel commented: "Our results have significant public health implications as around 70 million people worldwide have epilepsy, and emphasise that carefully assessing and treating psychiatric disorders as part as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients.

"Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy."

The study, which tracked 69,995 people with epilepsy born in Sweden between 1954 and 2009 for a 41-year period, found suicides and accidents accounted for almost 16 per cent of all deaths in people with epilepsy.

Of these, three-quarters also had been diagnosed with a psychiatric condition such as depression. They were the most common cause of death not linked to the underlying disease process.

The researchers also found that the risk of premature death in people with epilepsy compared similarly to their unaffected siblings and the general population. This suggests that epilepsy is an independent cause of early deaths, the academics said.

Simon Wigglesworth, deputy chief executive of Epilepsy Action, said the study was cause for concern.

"The findings of this research are concerning and highlight the need for excellent healthcare for people with epilepsy", Mr Wigglesworth said.

"Getting the best possible support and treatment is important to help to reduce the likelihood of people with epilepsy experiencing mental illness. And a holistic approach to managing the condition should help ensure that people with epilepsy get the best possible treatment for both their epilepsy and any associated conditions.”

A separate study published last week warned that children whose mothers take anti-epilepsy drugs during their pregnancy face an increased risk of developing autism.

By the age of three, children were four times more likely to show traits associated with autism if their mothers had taken drugs to control their epileptic seizures.

According to Epilepsy Research UK, around two-thirds of epileptic seizures can be successfully treated with anti-epileptic drugs.

In the latest study, the causes of death were compared with 660,869 people of the same age and sex from the general population, and 81,396 unaffected siblings of people with epilepsy, to account for the potential influence of genetic or environmental factors.

While in some 60 per cent of cases the cause for epilepsy is not known, some types are inherited and common causes are brain damage, scarring of the brain tissue, a tumour, or chemical and hormonal imbalances in the body.

Epilepsy is a neurological condition defined as the tendency to have recurrent seizures. There are around 40 different sorts of seizure and a person can suffer from more than one type.

Every day 87 people in the UK are diagnosed with epilepsy, and many people who develop epilepsy when they are below the age of 20 will “grow out of it” in adult life, according to Epilepsy Action.

While only 52 per cent of people with epilepsy in this country are seizure-free, the charity estimates that with the right treatment seven in 10 could avoid seizures.

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