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      The role of affective temperament and character traits in predicting suicidality in depressed patients Translated title: El papel del temperamento afectivo y los rasgos de carácter en la predicción de las tendencias suicidas en los pacientes depresivos

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          Abstract

          ABSTRACT The purpose of this study was to assess the relationship of affective temperaments and personality traits with suicide attempts in patients suffering from depression. A total of 251 patients diagnosed with recurrent depressive disorder or major depression episode were divided in groups with previous suicide attempts (n = 168) and without such attempts (n = 83) and given a sociodemographic questionnaire, TEMPS-A, and a personality questionnaire, VP+2-70. In all temperaments other than hyperthymic, higher scores were predominant in the group of patients with previous suicide attempts. The model including affective temperaments and personality traits successfully classified 72.5% of cases. Only depressive temperament was found to be a significant positive predictor with negative valence close to statistical significance. The cross-sectional design limits our ability to draw conclusions about causality and current affective status of the patients was not controlled for. However, our findings further prove the importance of affective temperament as a screening tool for suicide risk in depressed patients.

          Translated abstract

          RESUMEN El objetivo de este estudio fue evaluar la relación de los temperamentos afectivos y los rasgos de personalidad con los intentos de suicidio en pacientes que sufren depresión. Un total de 251 pacientes diagnosticados de trastorno depresivo recurrente o episodio de depresión mayor se dividió en dos grupos, uno con intentos de suicidio previos (n = 168) y otro sin estas tentativas (n = 83), a los que se aplicó un cuestionario sociodemográfico, TEMPS-A, y un cuestionario de personalidad, VP+2-70. En todos los temperamentos que no eran los hipertímicos las puntuaciones más altas se dieron predominantemente en el grupo de pacientes con tentativas de suicidio previas. El modelo que incluye temperamentos afectivos y rasgos de personalidad clasificó adecuadamente al 72.5% de los casos. Solo el temperamento depresivo apareció como predictor positivo significativo con valencia negativa cercana a la significación estadística. El diseño transversal limita nuestra capacidad para sacar conclusiones sobre la causalidad además de que no se controló el estado afectivo actual de los pacientes. Sin embargo, los resultados destacan aún más la importancia del temperamento afectivo como herramienta de detección del riesgo de suicidio en pacientes deprimidos.

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          Most cited references35

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          Risks of all-cause and suicide mortality in mental disorders: a meta-review.

          A meta-review, or review of systematic reviews, was conducted to explore the risks of all-cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of which 20 reported mortality risks in 20 different mental disorders and included over 1.7 million patients and over a quarter of a million deaths. All disorders had an increased risk of all-cause mortality compared with the general population, and many had mortality risks larger than or comparable to heavy smoking. Those with the highest all-cause mortality ratios were substance use disorders and anorexia nervosa. These higher mortality risks translate into substantial (10-20 years) reductions in life expectancy. Borderline personality disorder, anorexia nervosa, depression and bipolar disorder had the highest suicide risks. Notable gaps were identified in the review literature, and the quality of the included reviews was typically low. The excess risks of mortality and suicide in all mental disorders justify a higher priority for the research, prevention, and treatment of the determinants of premature death in psychiatric patients. Copyright © 2014 World Psychiatric Association.
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            Psychological autopsy studies of suicide: a systematic review.

            The psychological autopsy method offers the most direct technique currently available for examining the relationship between particular antecedents and suicide. This systematic review aimed to examine the results of studies of suicide that used a psychological autopsy method. A computer aided search of MEDLINE, BIDS ISI and PSYCHLIT, supplemented by reports known to the reviewers and reports identified from the reference lists of other retrieved reports. Two investigators systematically and independently examined all reports. Median proportions were determined and population attributable fractions were calculated, where possible, in cases of suicide and controls. One hundred and fifty-four reports were identified, of which 76 met the criteria for inclusion; 54 were case series and 22 were case-control studies. The median proportion of cases with mental disorder was 91% (95 % CI 81-98%) in the case series. In the case-control studies the figure was 90% (88-95%) in the cases and 27% (14-48%) in the controls. Co-morbid mental disorder and substance abuse also preceded suicide in more cases (38%, 19-57%) than controls (6%, 0-13%). The population attributable fraction for mental disorder ranged from 47-74% in the seven studies in which it could be calculated. The effects of particular disorders and sociological variables have been insufficiently studied to draw clear conclusions. The results indicated that mental disorder was the most strongly associated variable of those that have been studied. Further studies should focus on specific disorders and psychosocial factors. Suicide prevention strategies may be most effective if focused on the treatment of mental disorders.
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              Psychiatric diagnoses in 3275 suicides: a meta-analysis

              Background It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion. Methods We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables. Results Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0%) had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78–4.61), personality disorders (OR = 2.01; 95% CI: 1.38–2.95) and childhood disorders (OR = 4.95; 95% CI: 2.69–9.31) were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53–0.83), including depressive disorders (OR = 0.53; 95% CI: 0.42–0.68) were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides. Conclusions Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.
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                Author and article information

                Journal
                clinsa
                Clínica y Salud
                Clínica y Salud
                Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1130-5274
                2174-0550
                2021
                : 32
                : 1
                : 1-6
                Affiliations
                [02] orgnameUniversity of Belgrade Serbia
                [01] orgnameUniversity of Kragujevac Serbia
                Article
                S1130-52742021000100001 S1130-5274(21)03200100001
                10.5093/clysa2020a20
                de4aa3d9-7f69-4879-9ff5-a019025835bd

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 07 June 2020
                : 04 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 6
                Product

                SciELO Spain

                Categories
                Research Article

                Evaluación de riesgos,Suicide,Depression,Affective temperament,Character traits,Risk assessment,Suicidio,Depresión,Temperamento afectivo,Rasgos de carácter

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