Predictive testing for Alzheimer's disease: suicidal ideation in healthy participants.
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ABSTRACT:
SUBMITTER: Caselli RJ
PROVIDER: S-EPMC4543388 | biostudies-literature | 2015 Jul-Sep
REPOSITORIES: biostudies-literature
Publications
Predictive testing for Alzheimer's disease: suicidal ideation in healthy participants.
Caselli Richard J RJ Marchant Gary E GE Hunt Katherine S KS Henslin Bruce R BR Kosiorek Heidi E HE Langbaum Jessica J Robert Jason S JS Dueck Amylou C AC
Alzheimer disease and associated disorders 20150701 3
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Project description:ObjectiveThe prevalence of suicide in the United States has seen an increasing trend and is responsible for 1.6% of all mortality nationwide. Although suicide has the potential to broadly impact the entire population, it has a substantially increased prevalence in persons with epilepsy (PWE), despite many of these individuals consistently seeing a health care provider. The goal of this work is to predict the development of suicidal ideation (SI) in PWE using machine learning methodology such that providers can be better prepared to address suicidality at visits where it is likely to be prominent.MethodsThe current study leverages data collected at an epilepsy clinic during patient visits to predict whether an individual will exhibit SI at their next visit. The data used for prediction consisted of patient responses to questions about the severity of their epilepsy, issues with memory/concentration, somatic problems, markers for mental health, and demographic information. A machine learning approach was then applied to predict whether an individual would display SI at their following visit using only data collected at the prior visit.ResultsThe modeling approach allowed for the successful prediction of an individual's passive and active SI severity at the following visit (r = .42, r = .39) as well as the presence of SI regardless of severity (area under the curve [AUC] = .82, AUC = .8). This shows that the model was successfully able to synthesize the unique combination of an individual's responses to important questions during a clinical visit and utilize that information to indicate whether that individual will exhibit SI at their next visit.SignificanceThe results of this modeling approach allow the health care team to be prepared, in advance of a clinical visit, for the potential reporting of SI. By allowing the necessary support to be prepared ahead of time, it can be better integrated at the point of care, where patients are most likely to follow up on potential referrals or treatment.
| S-EPMC10129274 | biostudies-literature
Project description:BACKGROUND:Huntington disease (HD) is associated with increased risk of suicide. OBJECTIVE:This study compares suicide ideation in HD to the general population, assesses factors associated with increased prevalence of suicidal thoughts, and compares clinician-rated to self-reported assessments of suicidal ideation. METHODS:We examined 496 participants with premanifest or manifest HD. Clinician-rated suicidal ideation was measured using the Problem Behaviors Assessment - short form. Self-reported ideation was measured using two items from the HDQLIFE Concern with Death and Dying item bank. Independent sample t-tests were conducted to compare the prevalence of suicidal thoughts between our HD sample and the U.S. POPULATION:Logistic regression analyses were used to determine characteristics associated with higher odds of clinically significant suicidal ideation. Kappa agreement coefficients were calculated to evaluate concurrence between clinician-rated and self-reported assessments. RESULTS:Our sample had a significantly higher occurrence of suicidal ideation (19.76%) and suicidal plans (2.1%) than the general population (p < 0.0001). Odds of clinically significant suicidal ideation were 6.8 times higher in females (p = 0.04) on the clinician measure, and Hispanic/Latinos had 10.9 times higher odds than non-Hispanics (p = 0.025) on the self-report measure. Clinician-rated assessment had fair agreement (k = 0.2-0.4) with self-reported assessments, except in early stage HD where there was no overlap in the identification of participants with clinically significant suicidal ideation. DISCUSSION:Assessment for suicidal ideation and clinically significant suicidal thoughts in HD with a multimodal approach that includes clinician-rated and self-report measures is critical at all stages of the disease.
| S-EPMC6108173 | biostudies-other
Project description:BackgroundStudying the impact of COVID-19 on mental health is both compelling and imperative for the health care system's preparedness development. Discovering how pandemic conditions and governmental strategies and measures have impacted mental health is a challenging task. Mental health issues, such as depression and suicidal tendency, are traditionally explored through psychological battery tests and clinical procedures. To address the stigma associated with mental illness, social media is used to examine language patterns in posts related to suicide. This strategy enhances the comprehension and interpretation of suicidal ideation. Despite easy expression via social media, suicidal thoughts remain sensitive and complex to comprehend and detect. Suicidal ideation captures the new suicidal statements used during the COVID-19 pandemic that represents a different context of expressions.ObjectiveIn this study, our aim was to detect suicidal ideation by mining textual content extracted from social media by leveraging state-of-the-art natural language processing (NLP) techniques.MethodsThe work was divided into 2 major phases, one to classify suicidal ideation posts and the other to extract factors that cause suicidal ideation. We proposed a hybrid deep learning-based neural network approach (Bidirectional Encoder Representations from Transformers [BERT]+convolutional neural network [CNN]+long short-term memory [LSTM]) to classify suicidal and nonsuicidal posts. Two state-of-the-art deep learning approaches (CNN and LSTM) were combined based on features (terms) selected from term frequency-inverse document frequency (TF-IDF), Word2vec, and BERT. Explainable artificial intelligence (XAI) was used to extract key factors that contribute to suicidal ideation in order to provide a reliable and sustainable solution.ResultsOf 348,110 records, 3154 (0.9%) were selected, resulting in 1338 (42.4%) suicidal and 1816 (57.6%) nonsuicidal instances. The CNN+LSTM+BERT model achieved superior performance, with a precision of 94%, a recall of 95%, an F1-score of 94%, and an accuracy of 93.65%.ConclusionsConsidering the dynamic nature of suicidal behavior posts, we proposed a fused architecture that captures both localized and generalized contextual information that is important for understanding the language patterns and predict the evolution of suicidal ideation over time. According to Local Interpretable Model-Agnostic Explanations (LIME) and Shapley Additive Explanations (SHAP) XAI algorithms, there was a drift in the features during and before COVID-19. Due to the COVID-19 pandemic, new features have been added, which leads to suicidal tendencies. In the future, strategies need to be developed to combat this deadly disease.
| S-EPMC11786132 | biostudies-literature
Project description:Emergency department (ED) clinicians routinely decide the disposition of patients with suicidal ideation, with potential consequences for patient safety, liability, and system costs and resources. An expert consensus panel recently created a 6-item decision support tool for patients with passive or active suicidal ideation. Individuals scoring a 0 (exhibiting none of the tool's 6 items) are considered "lower risk" and suitable for discharge, while those with non-0 scores are considered "elevated risk" and should receive further evaluation. The current study tested the predictive utility of this tool using existing data from the Emergency Department Safety Assessment and Follow-up Evaluation. ED patients with active suicide ideation (n = 1368) were followed for 12 months after an index visit using telephone assessment and medical chart review. About 1 in 5 patients had attempted suicide during follow-up. Because of the frequency of serious warning signs and risk factors in this population, only three patients met tool criteria for "lower risk" at baseline. The tool had perfect sensitivity, but exceptionally low specificity, in predicting suicidal behavior within 6 weeks and 12 months. In logistic regression analyses, several tool items were significantly associated with suicidal behavior within 6 weeks (suicide plan, past attempt) and 12 months (suicide plan, past attempt, suicide intent, significant mental health condition, irritability/agitation/aggression). Although the tool did not perform well as a binary instrument among those with active suicidal ideation, having a suicide plan identified almost all attempters while suicide plan and past attempt identified over four-fifths of near-term attempts. (PsycINFO Database Record
| S-EPMC6082179 | biostudies-literature
Project description:Human genetic studies indicate that suicidal ideation and behavior are both heritable. Most studies have examined associations between aberrant gene expression and suicide behavior, but behavior risk is linked to severity of suicidal ideation. Through a gene network approach, this study investigates how gene co-expression patterns are associated with suicidal ideation and severity using RNA-seq data in peripheral blood from 46 live participants with elevated suicidal ideation and 46 with no ideation. Associations with presence of suicidal ideation were found within 18 co-expressed modules (p<0.05), as well as in 3 co-expressed modules associated with suicidal ideation severity (p<0.05, not explained by severity of depression). Suicidal ideation presence and severity-related gene modules with enrichment of genes involved in defense against microbial infection, inflammation, and adaptive immune response were identified, and investigated using RNA-seq data from postmortem brain that revealed gene expression differences with moderate effect sizes in suicide decedents vs. non-suicides in white matter, but not gray matter. Findings support a role of brain and peripheral blood inflammation in suicide risk, showing that suicidal ideation presence and severity are associated with an inflammatory signature detectable in blood and brain, indicating a biological continuity between ideation and suicidal behavior that may underlie a common heritability.
2024-03-06 | GSE247998 | GEO
Project description:IntroductionAbnormal cerebrospinal fluid amyloid beta (Aβ)42 and tau levels have been revealed decades before symptoms onset in Alzheimer's disease (AD); however, the examination is usually invasive and inaccessible to most people. We thus aimed to develop a non-invasive behavioral test that targets early potential cognitive changes to gauge cognitive decline. Specifically, we hypothesized that older cognitive healthy participants would exhibit comparable performance when the task was explicit and relied on conscious cognition. However, when the task was implicit, the performance of participants at high and low risks for AD would bifurcate. That is, early changes in unconscious cognition could be linked to cognitive health.MethodsWe measured implicit interference elicited by an imperceptible distractor in cognitively healthy elderly participants with normal (low risk) and pathological (high risk) Aβ42/total tau ratio. Participants were required to perform a Stroop task (word-naming or color-naming on an ink-semantics inconsistent word) with a visually masked distractor presented prior to the target task.ResultsWe found that, under a high-effort task (i.e., color-naming in the Stroop task), high-risk participants suffered interference when the imperceptible distractor and the subsequent target were incongruent in the responses they triggered. Their reaction times were slowed down by approximately 4%. This implicit interference was not found in the low-risk participants.DiscussionThese findings indicate that weakened inhibition of distracting implicit information can be a potential behavioral biomarker of early identification of AD pathology. Our study thus offers a new experimental paradigm to reveal early pathological aging by assessing how individuals respond to subperceptual threshold visual stimuli.
| S-EPMC9489163 | biostudies-literature
Project description:BackgroundChildhood trauma and over-general autobiographical memory (OGM) are crucial risk factors of suicide. This study aimed to investigate whether suicidal ideation was predicted by one's childhood trauma and OGM and the mechanism of OGM underlying suicidal ideation in depression patients and healthy controls.MethodsA total of 180 depression patients and 176 matched healthy individuals were recruited in this study. Data were analyzed using descriptive statistics, and Pearson's correlation coefficient was obtained. Path analysis was conducted to test a meditational model. The multigroup comparison was applied to find differences between groups.ResultsSignificant differences were detected between depression patients and healthy controls with respect to childhood trauma, OGM, suicidal ideation, and suicidal behavior. OGM was positively correlated with both current and worst-point suicidal ideation in the depression group and significantly correlated with worst-point suicidal ideation in the healthy control group. The path model showed that childhood trauma had a direct impact on the current suicidal ideation directly, and an indirect influence through OGM and worst-point suicidal ideation. Multigroup analysis further demonstrated that OGM affected and mediated the current suicidal ideation due to childhood trauma in depression patients, whereas only worst-point suicidal ideation was affected in healthy controls.ConclusionsThe OGM mediates suicidal ideation in depression patients, but only affects the worst-point suicidal ideation in the healthy controls. As it is one of the major risk factors of suicidal ideation in depression, amelioration of OGM might be an useful method to reduce or prevent suicidal ideation in depression patients.
| S-EPMC7549224 | biostudies-literature
Project description:Human genetic studies indicate that suicidal ideation and behavior are both heritable. Most studies have examined associations between aberrant gene expression and suicide behavior, but behavior risk is linked to severity of suicidal ideation. Through a gene network approach, this study investigates how gene co-expression patterns are associated with suicidal ideation and severity using RNA-seq data in peripheral blood from 46 live participants with elevated suicidal ideation and 46 with no ideation. Associations with presence of suicidal ideation were found within 18 co-expressed modules (p<0.05), as well as in 3 co-expressed modules associated with suicidal ideation severity (p<0.05, not explained by severity of depression). Suicidal ideation presence and severity-related gene modules with enrichment of genes involved in defense against microbial infection, inflammation, and adaptive immune response were identified, and investigated using RNA-seq data from postmortem brain that revealed gene expression differences with moderate effect sizes in suicide decedents vs. non-suicides in white matter, but not gray matter. Findings support a role of brain and peripheral blood inflammation in suicide risk, showing that suicidal ideation presence and severity are associated with an inflammatory signature detectable in blood and brain, indicating a biological continuity between ideation and suicidal behavior that may underlie a common heritability.
2024-03-06 | GSE248260 | GEO
Project description:ObjectiveTo examine the association between suicidal ideation (SI), 3 weeks, 3 months, and 6 months postpartum with demographic, psychosocial, clinical factors, and depressive/anxiety symptoms (measured 24-48 hours after delivery), among a cohort of postpartum women.MethodsThis study included 1,073 mothers who gave birth in a large tertiary New York City hospital (2009-2010). Later, self-report SI was assessed using the suicide measure from the Edinburgh Postnatal Depression Scale and from the Patient Health Questionnaire.ResultsTwo percent of participants presented with SI during the first 6 months postpartum. In bivariate analyses, race/ethnicity, nativity, insurance, and language were significantly correlated with SI 3 weeks, 3 months, and 6 months postpartum. Screening positive for depression (p = 0.0245) and anxiety (0.0454), assessed 1-2 days postpartum, was significantly correlated with later SI in bivariate analyses, as were antepartum complications (p = 0.001), depressive history (0.001), and self-efficacy (0.045). In adjusted models, antepartum complications (OR = 4.681, 95% CI = 1.99-10.99) and depressive history (OR-3.780, 95% CI = 1.514-9.441) were significantly associated with later postpartum SI. Heightened self-efficacy reduced the odds of later SI (p = 0.050).ConclusionFindings suggest that SI among a relatively healthy group of new mothers occurs with some frequency. Mothers with a history of depression and antepartum complications may be at increased risk.
| S-EPMC5175420 | biostudies-literature
Project description:BackgroundChildhood adversity predicts adolescent suicidal ideation but there are few studies examining whether the risk of childhood adversity extends to suicidal ideation in midlife. We hypothesized that childhood adversity predicts midlife suicidal ideation and this is partially mediated by adolescent internalizing disorders, externalizing disorders and adult exposure to life events and interpersonal difficulties.MethodAt 45 years, 9377 women and men from the UK 1958 British Birth Cohort Study participated in a clinical survey. Childhood adversity was prospectively assessed at the ages of 7, 11 and 16 years. Suicidal ideation at midlife was assessed by the depressive ideas subscale of the Revised Clinical Interview Schedule. Internalizing and externalizing disorders were measured by the Rutter scales at 16 years. Life events, periods of unemployment, partnership separations and alcohol dependence were measured through adulthood.ResultsIllness in the household, paternal absence, institutional care, parental divorce and retrospective reports of parental physical and sexual abuse predicted suicidal ideation at 45 years. Three or more childhood adversities were associated with suicidal ideation at 45 years [odds ratio (OR) 4.31, 95% confidence interval (CI) 2.67-6.94]. Psychological distress at 16 years partially mediated the associations of physical abuse (OR 3.41, 95% CI 2.29-5.75), sexual abuse (OR 4.99, 95% CI 2.90-11.16) with suicidal ideation. Adult life events partially mediated the association of parental divorce (OR 6.34, 95% CI -7.16 to 36.75) and physical (OR 9.59, 95% CI 4.97-27.88) and sexual abuse (OR 6.59, 95% CI 2.40-38.36) with suicidal ideation at 45 years.ConclusionsAdversity in childhood predicts suicidal ideation in midlife, partially mediated by adolescent internalizing and externalizing disorders, adult life events and interpersonal difficulties. Understanding the pathways from adversity to suicidal ideation can inform suicide prevention and the targeting of preventive interventions.
| S-EPMC5216460 | biostudies-literature