Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamen... more Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamental traits and psychiatric disorders in patients suffering from advanced disease are rare. This study investigated the influence of temperament on depression and anxiety in palliative care cancer patients. Methods A total of 53 patients at the palliative care unit (PCU) of the Medical University of Vienna were enrolled in the study. Patients filled out the TEMPS-M and the brief PHQ-9 questionnaires to examine associations between temperament, psychiatric symptoms and sociodemographic parameters. Results Pain (67%), anorexia (58%), constipation (42%) and nausea/vomiting (40%) were the most prevalent self-reported symptoms. Self-reported symptoms of depression were less commonly reported (21.8%) than unveiled by the structured assessment by the PHQ-9 questionnaire: 26.4% (n = 14) showed mild symptoms of depression and 64.1% (n = 34) had a major depressive disorder (MDD) according to PHQ-9. The depressive and cyclothymic temperaments showed significant associations with depressive (both: p < 0.001) as well as symptoms of anxiety (p = 0.002; p = 0.036). Furthermore, the anxious temperament was significantly associated with symptoms of depression (p = 0.027).
The individual capacity to love (CTL) has been linked to various mental health parameters and is ... more The individual capacity to love (CTL) has been linked to various mental health parameters and is considered to be an important outcome parameter of psychotherapeutic treatment. However, empirical examinations of the concept have not been conducted up to now. The aim of this study was to develop a valid and reliable instrument for the assessment of CTL [Capacity to Love Inventory (CTL-I)] as a trait of personality, which is shown to be related to clinically relevant symptoms and conditions. Four independent healthy samples in Austria ( = 547, = 174, and = 85) and Poland ( = 240) were assessed by a prototype of the CTL-I and its final shorter version in a confirmatory factor analysis (CFA). Internal consistency of the total questionnaire and each subscale was assessed by Cronbach alpha. External validity was measured against Beck Depression Inventory, Quality of Relationship Inventory, Sociosexual Orientation Inventory, Pathological Narcissism Inventory, and Narcissistic Personality I...
Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall ca... more Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall can influence suicidal behavior. This study analyses the relationship between seasonal changes and climatic variations and suicide attempts in 2131 young patients in Istanbul, Turkey. In our study sample, there was an association between suicide attempts in youths and seasonal changes, as suicide attempts occurred most frequently during summer in females as well as in males. Furthermore, there was a positive correlation between the mean temperature over the past 10 days and temperature at the index day and suicide attempts in females. After seasonality effects were mathematically removed, the mean temperature 10 days before a suicide attempt remained significant in males only, indicating a possible short-term influence of temperature on suicide attempts. This study shows an association between suicide attempts of young people and climatic changes, in particular temperature changes as well ...
International Journal of Psychiatry in Clinical Practice, 2017
Suicidal behavior of young people is a topic of utmost importance because suicide is irreversible... more Suicidal behavior of young people is a topic of utmost importance because suicide is irreversible, and should be prevented. Knowing about the psychosocial background and the triggering events could help in preventing suicidal behavior. We therefore aimed at identifying psychosocial factors that may trigger suicidal behavior in youth. We analyzed retrospectively the standardized records of 2232 youths aged ≤25 years, who were treated after a suicide attempt at emergency units of public hospitals in Istanbul, Turkey during a period of 1 year. We describe this population according to sex and socio-economic conditions, like educational, occupational, relationship status and link them with their reported reasons for suicide attempts. The majority of patients were female (81.6%, N = 1822 females, 18.4%, N = 410 males). Independent of their educational and occupational background, patients indicated most frequently intra-familial problems (females 45.8%, males 30.5%), intrapersonal problems (females 19.9%, males 18.5%), and relationship problems (females 11.3%, males 23.9%) as triggering reasons. Because intra-familial problems were the most frequently reported triggers of suicide attempts, preventive measures should focus on handling intra-familial conflicts. As sex differences were observed for the second-most common trigger-reasons, prevention should also focus on differentially handling intrapersonal and relationship conflicts better.
Child and adolescent psychiatry and mental health, 2017
Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that... more Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that there may be an association between monthly, diurnal and circadian changes and suicidal behaviours. In the present study we analysed retrospectively records of 2232 youth, who were treated in emergency units of state hospitals in Istanbul/Turkey after attempting suicide. The majority of the suicide attempters were females (81.6%). In both sexes, suicide attempts most frequently occurred at the beginning of the calendar week and between evening and midnight. This study shows that suicide attempts in youth follow diurnal and circadian changes. As suicide attempts of youth most frequently occurred at the beginning of the calendar week and between evening and midnight, health services such as specialized counselling for youth should especially be available during this time.
Ergebnisse Die lithiumreiche Region der Atacama-Region zeigt eine signifikant geringere Suizidrat... more Ergebnisse Die lithiumreiche Region der Atacama-Region zeigt eine signifikant geringere Suizidrate (9,99 pro 100.000) als andere chilenische Landesteile (12,50 pro 100.000) (t = 4,75; df = 18, p < 0,001). Schlussfolgerungen Chilenische Regionen, die reich an natürlich vorkommenden Lithiumsalzen sind, zeigen niedrigere Suizidmortalitätsraten im Vergleich zu anderen Regionen. Obwohl auf Grund des Studiendesigns keine Kausalität nachgewiesen werden kann, bestärken diese Resultate frühere Studien und unterstreichen die Notwendigkeit weiterer Forschung über die Effekte natürlich vorkommenden, gering dosierten Lithiums auf die psychische Gesundheit.
To evaluate the main prediction of the Interpersonal Theory of Suicide (IPTS): 3-way-interaction ... more To evaluate the main prediction of the Interpersonal Theory of Suicide (IPTS): 3-way-interaction of perceived burdensomeness (PB), thwarted belongingness (TB), and acquired capability (AC) for the prediction of suicidal behavior in a representative population sample. A total of 2513 participants completed measures of suicidal behavior, TB, PB, acquired capability (AC-FAD), and symptoms of depression and anxiety. The two-way-interaction of TB and PB, and the three-way interaction of TB, PB and AC-FAD predict suicidality. Given the cross-sectional nature of the data, conclusions on causality should be handled carefully. The main prediction of the IPTS has been proven in a general population sample.
Suicides account for over one million deaths per year worldwide and depression is among the most ... more Suicides account for over one million deaths per year worldwide and depression is among the most important risk factors. Epidemiological research into the relationship between antidepressant utilization and suicide mortality has shown heterogeneous and contradictory results. Different methodological approaches and limitations could at least partially explain varying results. This is the first study assessing the association of suicide mortality and antidepressant sales across Germany using complex statistical approaches in order to control for possible confounding factors including spatial dependency of data. German suicide counts were analyzed on a district level (n=402) utilizing ecological Poisson regressions within a hierarchical Bayesian framework. Due to significant spatial effects between adjacent districts spatial models were calculated in addition to a baseline non-spatial model. Models were adjusted for several confounders including socioeconomic variables, quality of psychosocial care, and depression prevalence. Separate analyses were performed for Eastern and Western Germany and for different classes of antidepressants (SSRIs and TCAs). Overall antidepressant sales were significantly negatively associated with suicide mortality in the non-spatial baseline model, while after adjusting for spatially structured and unstructured effects the association turned out to be insignificant. In sub-analyses, analogue results were found for SSRIs and TCAs separately. Suicide risk shows a distinct heterogeneous pattern with a pronounced relative risk in Southeast Germany. In conclusion, the results reflect the heterogeneous findings of previous studies on the association between suicide mortality and antidepressant sales and point to the complexity of this hypothesized link. Furthermore, the findings support tailored suicide preventive efforts within high risk areas.
Ptt Personlichkeitsstorungen Theorie Und Therapie, 2012
Suizidalitat hat aufgrund der hohen Pravalenz bei verschiedenen psychischen Storungen eine bedeut... more Suizidalitat hat aufgrund der hohen Pravalenz bei verschiedenen psychischen Storungen eine bedeutende Rolle. Affektive Storungen und Personlichkeitsstorungen werden in wissenschaftlichen Arbeiten als wesentliche Ursachen von Suizidalitat erlautert. Moderne Ansatze untersuchen neben den Klassifikationen psychischer Storungen eine zugrundeliegende Personlichkeitsorganisation als Erklarungsmodell fur Suizidalitat. Storungen der Impulskontrolle und aggressives Verhalten scheinen wesentliche maladaptive Aspekte der Personlichkeitsstruktur zu sein, die eine entscheidende Rolle in der Entwicklung suizidalen Verhaltens spielen. In der Untersuchung suizidalen Verhaltens sollte Defiziten im Bereich der Personlichkeitsstruktur neben der dimensionalen Diagnostik eine grosere Bedeutung zugemessen werden.
The aim of the present study was the validation of the Acquired Capability for Suicide Scale-Fear... more The aim of the present study was the validation of the Acquired Capability for Suicide Scale-Fearlessness about Death (ACSS-FAD) in a large population sample to further establish its reliability and validity, and to provide norm values. We assessed the ACSS-FAD, measures of depression, history of suicidal behavior, and anxiety in a representative sample of the German population (N=2513) and analyzed its dimensionality, invariance across sex and construct validity by means of confirmatory factor analysis, correlational analysis and analysis of variance. The one-factorial structure achieved satisfactory model fit after introducing several correlating error terms. Across sex, partial scalar invariance could be established. Depression and anxiety showed negative associations with the ACSS-FAD while no relation with past suicidal behavior was found. Because mean scores in the ACSS-FAD were affected by sex and age group, sex and age-specific norm values were calculated. Our findings support the one-factorial structure of the ACSS-FAD when the measurement model is slightly modified, pointing out the need of revising the wording of some items. The validity of the measure should be further examined in clinical samples.
IntroductionIt is known from previous studies that suicide follows a seasonal pattern with a peak... more IntroductionIt is known from previous studies that suicide follows a seasonal pattern with a peak in spring.ObjectivesAnalyze whether suicidal behavior is associated with the increase in the duration of sunshine in spring.AimsTo investigate the effect of number of sunshine hours per month on suicide rates in Austria between 1996–2006.MethodsSuicide data, differentiated by month of suicide, gender, and method of suicide (violent vs. non-violent methods), were provided by Statistics Austria. Data on the average number of sunshine hours per month were provided by the Austrian Central Institute for Meteorology. For statistical analysis ANOVA tests and Pearson correlation tests were used.ResultsSuicide frequencies were highest between March and May, lowest between November and January (df = 11, F = 5.2, p < .0001). The average number of sunshine hours per month was significantly correlated with the number of suicides among both genders r = .43 (p < .0001), violent methods (r = .48;...
Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamen... more Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamental traits and psychiatric disorders in patients suffering from advanced disease are rare. This study investigated the influence of temperament on depression and anxiety in palliative care cancer patients. Methods A total of 53 patients at the palliative care unit (PCU) of the Medical University of Vienna were enrolled in the study. Patients filled out the TEMPS-M and the brief PHQ-9 questionnaires to examine associations between temperament, psychiatric symptoms and sociodemographic parameters. Results Pain (67%), anorexia (58%), constipation (42%) and nausea/vomiting (40%) were the most prevalent self-reported symptoms. Self-reported symptoms of depression were less commonly reported (21.8%) than unveiled by the structured assessment by the PHQ-9 questionnaire: 26.4% (n = 14) showed mild symptoms of depression and 64.1% (n = 34) had a major depressive disorder (MDD) according to PHQ-9. The depressive and cyclothymic temperaments showed significant associations with depressive (both: p < 0.001) as well as symptoms of anxiety (p = 0.002; p = 0.036). Furthermore, the anxious temperament was significantly associated with symptoms of depression (p = 0.027).
The individual capacity to love (CTL) has been linked to various mental health parameters and is ... more The individual capacity to love (CTL) has been linked to various mental health parameters and is considered to be an important outcome parameter of psychotherapeutic treatment. However, empirical examinations of the concept have not been conducted up to now. The aim of this study was to develop a valid and reliable instrument for the assessment of CTL [Capacity to Love Inventory (CTL-I)] as a trait of personality, which is shown to be related to clinically relevant symptoms and conditions. Four independent healthy samples in Austria ( = 547, = 174, and = 85) and Poland ( = 240) were assessed by a prototype of the CTL-I and its final shorter version in a confirmatory factor analysis (CFA). Internal consistency of the total questionnaire and each subscale was assessed by Cronbach alpha. External validity was measured against Beck Depression Inventory, Quality of Relationship Inventory, Sociosexual Orientation Inventory, Pathological Narcissism Inventory, and Narcissistic Personality I...
Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall ca... more Seasonal changes and climatic factors like ambient temperature, sunlight duration and rainfall can influence suicidal behavior. This study analyses the relationship between seasonal changes and climatic variations and suicide attempts in 2131 young patients in Istanbul, Turkey. In our study sample, there was an association between suicide attempts in youths and seasonal changes, as suicide attempts occurred most frequently during summer in females as well as in males. Furthermore, there was a positive correlation between the mean temperature over the past 10 days and temperature at the index day and suicide attempts in females. After seasonality effects were mathematically removed, the mean temperature 10 days before a suicide attempt remained significant in males only, indicating a possible short-term influence of temperature on suicide attempts. This study shows an association between suicide attempts of young people and climatic changes, in particular temperature changes as well ...
International Journal of Psychiatry in Clinical Practice, 2017
Suicidal behavior of young people is a topic of utmost importance because suicide is irreversible... more Suicidal behavior of young people is a topic of utmost importance because suicide is irreversible, and should be prevented. Knowing about the psychosocial background and the triggering events could help in preventing suicidal behavior. We therefore aimed at identifying psychosocial factors that may trigger suicidal behavior in youth. We analyzed retrospectively the standardized records of 2232 youths aged ≤25 years, who were treated after a suicide attempt at emergency units of public hospitals in Istanbul, Turkey during a period of 1 year. We describe this population according to sex and socio-economic conditions, like educational, occupational, relationship status and link them with their reported reasons for suicide attempts. The majority of patients were female (81.6%, N = 1822 females, 18.4%, N = 410 males). Independent of their educational and occupational background, patients indicated most frequently intra-familial problems (females 45.8%, males 30.5%), intrapersonal problems (females 19.9%, males 18.5%), and relationship problems (females 11.3%, males 23.9%) as triggering reasons. Because intra-familial problems were the most frequently reported triggers of suicide attempts, preventive measures should focus on handling intra-familial conflicts. As sex differences were observed for the second-most common trigger-reasons, prevention should also focus on differentially handling intrapersonal and relationship conflicts better.
Child and adolescent psychiatry and mental health, 2017
Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that... more Different psychosocial factors might have an impact on suicidal behaviour and evidence shows that there may be an association between monthly, diurnal and circadian changes and suicidal behaviours. In the present study we analysed retrospectively records of 2232 youth, who were treated in emergency units of state hospitals in Istanbul/Turkey after attempting suicide. The majority of the suicide attempters were females (81.6%). In both sexes, suicide attempts most frequently occurred at the beginning of the calendar week and between evening and midnight. This study shows that suicide attempts in youth follow diurnal and circadian changes. As suicide attempts of youth most frequently occurred at the beginning of the calendar week and between evening and midnight, health services such as specialized counselling for youth should especially be available during this time.
Ergebnisse Die lithiumreiche Region der Atacama-Region zeigt eine signifikant geringere Suizidrat... more Ergebnisse Die lithiumreiche Region der Atacama-Region zeigt eine signifikant geringere Suizidrate (9,99 pro 100.000) als andere chilenische Landesteile (12,50 pro 100.000) (t = 4,75; df = 18, p < 0,001). Schlussfolgerungen Chilenische Regionen, die reich an natürlich vorkommenden Lithiumsalzen sind, zeigen niedrigere Suizidmortalitätsraten im Vergleich zu anderen Regionen. Obwohl auf Grund des Studiendesigns keine Kausalität nachgewiesen werden kann, bestärken diese Resultate frühere Studien und unterstreichen die Notwendigkeit weiterer Forschung über die Effekte natürlich vorkommenden, gering dosierten Lithiums auf die psychische Gesundheit.
To evaluate the main prediction of the Interpersonal Theory of Suicide (IPTS): 3-way-interaction ... more To evaluate the main prediction of the Interpersonal Theory of Suicide (IPTS): 3-way-interaction of perceived burdensomeness (PB), thwarted belongingness (TB), and acquired capability (AC) for the prediction of suicidal behavior in a representative population sample. A total of 2513 participants completed measures of suicidal behavior, TB, PB, acquired capability (AC-FAD), and symptoms of depression and anxiety. The two-way-interaction of TB and PB, and the three-way interaction of TB, PB and AC-FAD predict suicidality. Given the cross-sectional nature of the data, conclusions on causality should be handled carefully. The main prediction of the IPTS has been proven in a general population sample.
Suicides account for over one million deaths per year worldwide and depression is among the most ... more Suicides account for over one million deaths per year worldwide and depression is among the most important risk factors. Epidemiological research into the relationship between antidepressant utilization and suicide mortality has shown heterogeneous and contradictory results. Different methodological approaches and limitations could at least partially explain varying results. This is the first study assessing the association of suicide mortality and antidepressant sales across Germany using complex statistical approaches in order to control for possible confounding factors including spatial dependency of data. German suicide counts were analyzed on a district level (n=402) utilizing ecological Poisson regressions within a hierarchical Bayesian framework. Due to significant spatial effects between adjacent districts spatial models were calculated in addition to a baseline non-spatial model. Models were adjusted for several confounders including socioeconomic variables, quality of psychosocial care, and depression prevalence. Separate analyses were performed for Eastern and Western Germany and for different classes of antidepressants (SSRIs and TCAs). Overall antidepressant sales were significantly negatively associated with suicide mortality in the non-spatial baseline model, while after adjusting for spatially structured and unstructured effects the association turned out to be insignificant. In sub-analyses, analogue results were found for SSRIs and TCAs separately. Suicide risk shows a distinct heterogeneous pattern with a pronounced relative risk in Southeast Germany. In conclusion, the results reflect the heterogeneous findings of previous studies on the association between suicide mortality and antidepressant sales and point to the complexity of this hypothesized link. Furthermore, the findings support tailored suicide preventive efforts within high risk areas.
Ptt Personlichkeitsstorungen Theorie Und Therapie, 2012
Suizidalitat hat aufgrund der hohen Pravalenz bei verschiedenen psychischen Storungen eine bedeut... more Suizidalitat hat aufgrund der hohen Pravalenz bei verschiedenen psychischen Storungen eine bedeutende Rolle. Affektive Storungen und Personlichkeitsstorungen werden in wissenschaftlichen Arbeiten als wesentliche Ursachen von Suizidalitat erlautert. Moderne Ansatze untersuchen neben den Klassifikationen psychischer Storungen eine zugrundeliegende Personlichkeitsorganisation als Erklarungsmodell fur Suizidalitat. Storungen der Impulskontrolle und aggressives Verhalten scheinen wesentliche maladaptive Aspekte der Personlichkeitsstruktur zu sein, die eine entscheidende Rolle in der Entwicklung suizidalen Verhaltens spielen. In der Untersuchung suizidalen Verhaltens sollte Defiziten im Bereich der Personlichkeitsstruktur neben der dimensionalen Diagnostik eine grosere Bedeutung zugemessen werden.
The aim of the present study was the validation of the Acquired Capability for Suicide Scale-Fear... more The aim of the present study was the validation of the Acquired Capability for Suicide Scale-Fearlessness about Death (ACSS-FAD) in a large population sample to further establish its reliability and validity, and to provide norm values. We assessed the ACSS-FAD, measures of depression, history of suicidal behavior, and anxiety in a representative sample of the German population (N=2513) and analyzed its dimensionality, invariance across sex and construct validity by means of confirmatory factor analysis, correlational analysis and analysis of variance. The one-factorial structure achieved satisfactory model fit after introducing several correlating error terms. Across sex, partial scalar invariance could be established. Depression and anxiety showed negative associations with the ACSS-FAD while no relation with past suicidal behavior was found. Because mean scores in the ACSS-FAD were affected by sex and age group, sex and age-specific norm values were calculated. Our findings support the one-factorial structure of the ACSS-FAD when the measurement model is slightly modified, pointing out the need of revising the wording of some items. The validity of the measure should be further examined in clinical samples.
IntroductionIt is known from previous studies that suicide follows a seasonal pattern with a peak... more IntroductionIt is known from previous studies that suicide follows a seasonal pattern with a peak in spring.ObjectivesAnalyze whether suicidal behavior is associated with the increase in the duration of sunshine in spring.AimsTo investigate the effect of number of sunshine hours per month on suicide rates in Austria between 1996–2006.MethodsSuicide data, differentiated by month of suicide, gender, and method of suicide (violent vs. non-violent methods), were provided by Statistics Austria. Data on the average number of sunshine hours per month were provided by the Austrian Central Institute for Meteorology. For statistical analysis ANOVA tests and Pearson correlation tests were used.ResultsSuicide frequencies were highest between March and May, lowest between November and January (df = 11, F = 5.2, p < .0001). The average number of sunshine hours per month was significantly correlated with the number of suicides among both genders r = .43 (p < .0001), violent methods (r = .48;...
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