@article{3169443,
    title = "Sleep disturbance as a proximal predictor of suicidal intent in recently
hospitalized attempters",
    author = "Ferentinos, Panagiotis and Porichi, Evgenia and Christodoulou, Christos and and Dikeos, Dimitris and Papageorgiou, Charalambos and Douzenis, and Athanassios",
    journal = "Sleep Medicine",
    year = "2016",
    volume = "19",
    pages = "1-7",
    publisher = "ELSEVIER SCIENCE BV",
    issn = "1389-9457",
    doi = "10.1016/j.sleep.2015.10.021",
    keywords = "Age; Alcohol; Depression; Insomnia; Short sleep duration; Suicidal
intent",
    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.
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).
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.
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 partiallymediated 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. (C) 2015 Elsevier B. V. All rights reserved."
}