Journal
EUROPEAN ARCHIVES OF PSYCHIATRY AND CLINICAL NEUROSCIENCE
Volume 272, Issue 5, Pages 887-896Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00406-021-01375-4
Keywords
Suicidal ideation; Major depressive disorder; Stress sensitization; Childhood adversity; Stressful life events
Categories
Funding
- National Key Basic Research Program of China (973 Program) [2013CB531305]
- National Key Technology R and D Program [2015BAI13B01]
- National Natural Science Foundation of China [81630031]
- Beijing Municipal Science and Technology Project [Z171100000117016]
- Capital Medical Development Research Fund [2020-2-4113]
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The stress sensitization model suggests that early adversity increases vulnerability to psychiatric disorders by sensitizing individuals to subsequent proximal stress. This study confirms the hypothesis that stress sensitization influences suicidal ideation in patients with major depressive disorder (MDD). Focusing on stress sensitization can improve early identification and timely intervention for MDD patients at risk of suicide.
The stress sensitization model indicates that early adversity (e.g., childhood stress) sensitizes individuals to subsequent proximal stress (e.g., stressful life events in adult life), thereby increasing their vulnerability to psychiatric disorders. However, the effect of stress sensitization on suicidality in patients with major depressive disorder (MDD) has not been previously investigated. Data for the present study were derived from the Objective Diagnostic Markers and Personalized Intervention in MDD Patients (ODMPIM) study. The psychiatric diagnosis and suicidal ideation were evaluated by the Mini-International Neuropsychiatric Interview (M.I.N.I.). We used a multiple logistic analysis to examine the association among childhood adversity (CA), adulthood adversity (AA) and suicidal ideation. Among 1084 MDD patients, 48.6% had suicidal ideation and 65.6% experienced life adversity during their childhood or adulthood. Patients who reported suicidal ideation were more likely to report CA (46.7% vs. 38.7%, P = 0.008) or AA (49.5% vs. 40.9%, P = 0.004) than patients without suicidal ideation. Patients who experienced two waves of adversity (both CA and AA) were associated with higher rates of suicidal ideation (odds ratio = 1.68, 95% CI = 1.19-2.37, P = 0.003); however, neither CA nor AA alone was associated with suicidal ideation. This study first verifies the hypothesis of stress sensitization on suicidal ideation in patients with MDD. Focusing on stress sensitization may enhance the early identification of MDD patients at suicidal risk and the ability to provide timely and appropriate intervention. Clinicaltrials.gov identifier: NCT02023567.
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