Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder

Elizabeth D Ballard; Jennifer L Vande Voort; Rebecca A Bernert; David A Luckenbaugh; Erica M Richards; Mark J Niciu; Maura L Furey; Wallace C Duncan Jr; Carlos A Zarate Jr

doi:10.4088/JCP.15m09943

Back

Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder

Journal article

Open access

Peer reviewed

Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder

Elizabeth D Ballard, Jennifer L Vande Voort, Rebecca A Bernert, David A Luckenbaugh, Erica M Richards, Mark J Niciu, Maura L Furey, Wallace C Duncan Jr and Carlos A Zarate Jr

The journal of clinical psychiatry, Vol.77(6), pp.825-831

06/2016

DOI: 10.4088/JCP.15m09943

PMCID: PMC5103284

PMID: 27337418

Files and links (1)

url

http://doi.org/10.4088/JCP.15m09943View

Open Access

Abstract

Self-reported sleep disturbances may confer elevated risk for suicidal ideation, suicide attempts, and death. However, limited research has evaluated polysomnographically determined sleep disturbance as an acute physiologic risk factor for suicidal thoughts. This study sought to investigate the relationship between nocturnal wakefulness in association with next-day suicidal ideation using overnight polysomnography assessment from data collected between 2006 and 2013. Sixty-five participants with DSM-IV-diagnosed major depressive disorder or bipolar depression underwent overnight polysomnography monitoring in a sleep laboratory. The Hamilton Depression Rating Scale (HDRS) was administered the morning after polysomnography recording to assess next-day suicidal ideation, severity of depressive symptoms, and subjective sleep disturbances. Using a generalized linear mixed model, a significant time-by-ideation interaction was found indicating greater nocturnal wakefulness at 4:00 am among participants with suicidal ideation (F4,136 = 3.65, P = .007). Increased time awake during the 4:00 am hour (4:00 to 4:59) was significantly associated with elevated suicidal thoughts the next day (standardized β = 0.31, P = .008). This relationship persisted after controlling for age, gender, diagnosis, and severity of depressive symptoms. Greater nocturnal wakefulness, particularly in the early morning hours, was significantly associated with next-day suicidal thoughts. Polysomnographically documented sleep disruption at specific times of night may represent an acute risk factor of suicidal ideation that warrants additional research. ClinicalTrials.gov identifier: NCT00024635.

United States

Humans

Middle Aged

Suicide - prevention & control

Suicide, Attempted - statistics & numerical data

Male

Suicidal Ideation

Statistics as Topic

Depressive Disorder, Major - epidemiology

Cause of Death

Incidence

Sleep Initiation and Maintenance Disorders - epidemiology

Young Adult

Wakefulness

Suicide - psychology

Adult

Female

Cross-Sectional Studies

Risk Factors

Circadian Rhythm

Polysomnography

Suicide - statistics & numerical data

Bipolar Disorder - psychology

Depressive Disorder, Major - psychology

Suicide, Attempted - psychology

Health Surveys

Adolescent

Aged

Bipolar Disorder - epidemiology

Sleep Initiation and Maintenance Disorders - psychology

Details

Title: Subtitle: Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder
Creators: Elizabeth D Ballard - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Jennifer L Vande Voort - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Rebecca A Bernert - Suicide Prevention Research Laboratory, Stanford Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
David A Luckenbaugh - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Erica M Richards - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Mark J Niciu - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Maura L Furey - Janssen Pharmaceuticals, Neuroscience Research and Development, La Jolla, California, USA
Wallace C Duncan Jr - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Carlos A Zarate Jr - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Resource Type: Journal article
Publication Details: The journal of clinical psychiatry, Vol.77(6), pp.825-831
DOI: 10.4088/JCP.15m09943
PMID: 27337418
PMCID: PMC5103284
NLM abbreviation: J Clin Psychiatry
ISSN: 0160-6689
eISSN: 1555-2101
Publisher: United States
Grant note: Z01 MH002857-04 / Intramural NIH HHS Z99 MH999999 / Intramural NIH HHS ZIA MH002927-07 / Intramural NIH HHS K23 MH093490 / NIMH NIH HHS
Language: English
Date published: 06/2016
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003956702771

Metrics

43 Record Views

64 Times Cited - Web of Science

See more details

Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder

Files and links (1)

Related content

Abstract

Details

Metrics