@article{ref1,
title="Sleep disturbance as a proximal predictor of suicidal intent in recently hospitalized attempters",
journal="Sleep Medicine",
year="2016",
author="Ferentinos, Panagiotis and Porichi, Evgenia and Christodoulou, Christos and Dikeos, Dimitris and Papageorgiou, Charalambos and Douzenis, Athanassios",
volume="19",
number="",
pages="1-7",
abstract="OBJECTIVES: Insomnia and short self-reported sleep duration are associated with suicidality, adjusting for concurrent depression. Yet, it is unknown whether they correlate with attempters' suicidal intent and the lethality of suicidal acts. This cross-sectional study in hospitalized suicide attempters aimed to investigate whether temporally proximal self-reported sleep disturbance predicts suicidal intent or exerts mediatory effects. <br><br>METHODS: Attempters were retrospectively assessed for insomnia severity (Athens Insomnia Scale [AIS]) and average night sleep duration (ANSD) for 2 weeks preceding attempt. The effects of insomnia or ANSD on suicidal intent (Beck's Suicide Intent Scale [BSIS]) were explored in multiple regressions. Mediatory effects were investigated in structural equation models (SEMs). <br><br>RESULTS: A total of 127 adults (59.8% females) were interviewed within two weeks post-suicide attempt. Major psychiatric diagnoses included affective, psychotic, and alcohol-related disorders. Of the participants, 38.6% had current major depression (MDE). A total of 62.2% reported insomnia (AIS ≥ 6); 42.5% reported short ANSD (≤5 hours). BSIS was predicted by AIS (p = 0.034), short ANSD (p = 0.015), or insomnia with short ANSD (p = 0.006). In SEMs, indirect effects of current MDE, affective disorder, and alcohol-related disorder diagnoses on BSIS via AIS tested significant; both AIS and short ANSD partially mediated the effect of age on BSIS. <br><br>CONCLUSION: Insomnia, short ANSD, and, in particular, insomnia with short ANSD proximally predicted suicidal intent in recent attempters. The effects of current depression and affective and alcohol-related disorder diagnoses on suicidal intent were partially mediated by insomnia; both insomnia and short ANSD partially mediated the effect of age on suicidal intent. Therefore, management of sleep disturbance in at-risk subjects is important, as it may reduce unfavorable outcomes of suicidal acts.<br><br>Copyright © 2015 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1389-9457",
doi="10.1016/j.sleep.2015.10.021",
url="http://dx.doi.org/10.1016/j.sleep.2015.10.021"
}