Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.
Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, Hopital Bichat - Claude Bernard, Paris, France.
World J Biol Psychiatry. 2024 Sep;25(7):408-416. doi: 10.1080/15622975.2024.2391456. Epub 2024 Aug 20.
Suicide is a widespread problem, with risk factors still a challenge. The aim was to assess correlations among insomnia, circadian rhythm, and inflammatory markers in individuals who attempted suicide.
Consecutive patients hospitalised following an attempted suicide, were assessed. Psychiatric diagnosis (DSM-5-TR Criteria), lethality of the suicide attempt (Suicide Intent Scale-SIS), and inflammatory parameters NLR (neutrophil-lymphocyte ratio) PLR (platelet-lymphocyte ratio), and SII (systemic inflammation index/neutrophil-to-platelet ratio on lymphocytes), were computed. Depressive and manic symptoms (Beck Depression Inventory-BDI-II, Young Mania Rating Scale- YMRS), circadian rhythms disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry-BRIAN), insomnia symptoms (Insomnia Severity Index-ISI) were assessed together with socio-demographic, clinical and pharmacological data.
The final sample included 52 individuals. Patients who experienced insomnia during the preceding two weeks utilised high lethality methods, reported heightened dysregulation of chronobiological rhythms, heightened severity of depression, and elevated levels of inflammatory markers. High lethality was best predicted by insomnia symptoms (OR = 20.1, CI-95% 4.66-87.25, = 0.001), by disturbances of circadian rhythms (OR = 6.97, CI-95% 1.82-26.66, = 0.005), and by NLR indices (OR 4.00, CI-95% 1.14-13.99, = 0.030).
Sleep disturbances may be a risk factor for suicidal lethality, along with markers of inflammation. It is plausible that insomnia and circadian sleep dysregulation may contribute to inflammation, thereby promoting suicidal risk.
自杀是一个普遍存在的问题，其风险因素仍然是一个挑战。本研究旨在评估失眠、昼夜节律和炎症标志物在自杀未遂者中的相关性。
连续评估因自杀未遂而住院的患者。使用DSM-5-TR 标准进行精神科诊断，使用自杀意念量表（SIS）评估自杀未遂的致命性，计算中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和系统性炎症指数/中性粒细胞与血小板比值 on lymphocytes（SII）等炎症参数。评估抑郁和躁狂症状（贝克抑郁量表第二版（BDI-II），Young 躁狂评定量表（YMRS））、昼夜节律紊乱（神经精神病学生物节律评估访谈- BRIAN）、失眠症状（失眠严重程度指数（ISI））以及社会人口学、临床和药理学数据。
最终样本包括 52 名患者。在过去两周内经历失眠的患者使用高致命性方法，报告昼夜节律生物节律紊乱程度更高，抑郁严重程度更高，炎症标志物水平升高。失眠症状（OR = 20.1，CI-95% 4.66-87.25， = 0.001）、昼夜节律紊乱（OR = 6.97，CI-95% 1.82-26.66， = 0.005）和 NLR 指数（OR 4.00，CI-95% 1.14-13.99， = 0.030）是高致命性的最佳预测因素。
睡眠障碍可能是自杀致命性的一个风险因素，同时还有炎症标志物。失眠和昼夜节律睡眠紊乱可能会导致炎症，从而增加自杀风险。
