A resting state EEG study on depressed persons with suicidal ideation.

Background: Major Depressive Disorder (MDD) is a psychiatric illness that is often associated with potentially life-threatening physiological changes and increased risk for suicidal behavior. Electroencephalography (EEG) research suggests an association between depression and specific frequency imbalances in the frontal brain region. Further, while recently developed technology has been proposed to simplify EEG data acquisition, more research is still needed to support its use in patients with MDD. Methods: Using the 14-channel EMOTIV EPOC cap, we recorded resting state EEG from 15 MDD patients with and MDD persons with suicidal ideation (SI) vs. 12 healthy controls (HC) to investigate putative power spectral density (PSD) between-group differences at the F3 and F4 electrode sites. Specifically, we explored 1) between-group alpha power asymmetries (AA), 2) between-group differences in delta, theta, alpha and beta power, 3) between PSD data and the scores in the Beck's Depression Inventory-II (BDI-II), Beck's Anxiety Inventory (BAI), Reasons for Living Inventory (RFL), and Self-Disgust Questionnaire (SDS). Results: When compared to HC, patients had higher scores on the BAI (p = 0.0018), BDI-II (p = 0.0001) or SDS (p = 0.0142) scale and lower scores in the RFL (p = 0.0006) scale. The PSD analysis revealed no between-group difference or correlation with questionnaire scores for any of the measures considered. Conclusions: The present study could not confirm previous research suggesting frequency-specific anomalies in depressed persons with SI but might suggest that frontal EEG imbalances reflect greater anxiety and negative self-referencing. Future studies should confirm these findings in a larger population sample.

Using Resting State Heart Rate Variability and Skin Conductance Response to Detect Depression in Adults.

Depression is the leading cause of disability worldwide, yet rates of missed- and mis-diagnoses are alarmingly high. The introduction of objective biomarkers, to aid diagnosis, informed by depression's physiological pathology may alleviate some of the burden on strained mental health services. Three minutes of eyes-closed resting state heart rate and skin conductance response (SCR) data were acquired from 27 participants (16 healthy controls, 11 with major depressive disorder (MDD)). Various classifiers were trained on state-of-the-art and novel features. We are aware of no previous studies analysing the utility of multimodal vs. individual modalities for classification. We found no improvement using multimodal classifiers over using heart rate variability (HRV) alone, which achieved 81% test accuracy. The best multimodal and SCR only classifiers were only slightly less accurate at 78%. Despite not improving depression detection, SCR features did show stronger correlation with suicidal ideation than HRV. SD1/SD22 is a novel HRV feature proposed in this paper, similar to the commonly used ratio SD1/SD2 but with more marked separation between classes, having the largest Rank Biserial Correlation of all examined features (p-value = 0.002, RBC = -0.73). We recommend further studies in this area.

Globus pallidus deep brain stimulators for a case of severe neuroleptic-related dystonia and dyskinesia.

We report a 45 year old man with neuroleptic-induced dyskinesia for whom deep brain stimulators (DBS) were implanted in the globus pallidus internus (GPi). We describe a significant improvement in his symptoms. Lastly, we review briefly the success of deep brain stimulation to date, and discuss the clinical implications for individuals who develop movement disorders during neuroleptic use.

Socioeconomic change and suicide: a time-series study from the Republic of Ireland.

This ecological study examined the association between seven socioeconomic indicators (GDP, unemployment rate, female labor force participation rate, alcohol expenditure, marriage rate, percentage of births outside of marriage, and indictable crime rate) and total, male, and female rates of suicide and suicide plus undetermined death in Ireland during the period 1968-2000. Analysis of the data expressed as absolute values showed highly significant associations between the socioeconomic indicators and the total, male, and female suicide rates. However, these associations were explained by the strongly trended data. The trended nature of the data was removed by using year-to-year differences. Analysis of the first-differenced data showed that none of the socioeconomic indicators was associated with the total, male, or female suicide rates with the exception of indictable crime, which had a significant independent effect on the female suicide rate (coefficient = 2.0, p < .01) but not on suicide plus undetermined death. This study highlights the need to use econometric methods in time-trend analyses, the lack of age-sex specific exposure data in this area, and the challenge of understanding trends in suicide in their socioeconomic context.

Three case reports of emergent dyskinesia with clozapine.

Clozapine is indicated for the treatment of patients intolerant of conventional antipsychotic agents. It is often used to treat those patients who have developed movement disorders while on conventional antipsychotics. We report three cases of dyskinesia associated with clozapine induction. We suggest a mechanism that might explain an underlying dopaminergic hypersensitivity during this transitional period. Further, we identify groups that might be at high risk of developing dyskinesia and suggest strategies to reduce risk especially in these groups.

Suicide outside of prison settings among males under investigation for sex offenses in Ireland during 1990 to 1999.

Thirty-two cases of suicide outside prison were identified among 7008 Irish men under investigation for sexual offenses between 1990 and 1999. Previously this risk category has not been identified. Risk ratios of 1/1644 for those accused of offenses against adults, and 1/24 for those accused of offending against minors, respectively, were estimated based on the conservative estimates found here. The increase in the base rate of suicide in Ireland during the study period is an insufficient explanation. The frequency is comparable to prison suicides for the period, and the population of risk may overlap. The incidence increases over the study period. It outpaces increases in prosecutions and may reflect responses to the changing social environment of these investigations. These men use community psychiatric services that may need to become aware of the increased risk of suicide they pose.