Massimiliano Orri1, Lea C Perret1, Gustavo Turecki1, Marie-Claude Geoffroy2. 1. McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada. 2. Department of Educational and Counselling Psychology, McGill University, Montreal, Canada. Electronic address: marie-claude.geoffroy@mcgill.ca.
Abstract
BACKGROUND: Irritability is gaining considerable attention as a risk factor for suicide-related outcomes (suicide mortality, attempt, and ideation). However, the evidence of this association is scant. We conducted a systematic review of the evidence regarding the associations between irritability and suicide-related outcomes across the life-course. METHODS: We conducted a systematic search on Medline and PsycINFO (up to January 2018) for original articles published in English investigating the association between irritability and suicide-related outcomes. Two researchers independently screened the articles, assessed the quality of the evidence (New-Castle-Ottawa Scale) and extracted study characteristics. RESULTS: Thirty-nine studies were retrieved, most were of low/medium quality. Twelve assessed irritability in childhood/adolescence (6 in community samples, 6 in clinical samples) and 27 in adulthood (7 in community samples, 20 in clinical samples). In both childhood/adolescence and adult samples, most community-based studies reported a positive association between irritability and suicidal ideation and/or attempt, while clinical studies reported mixed findings. More specifically, in clinical studies, the association of irritability with suicide-related outcomes (i) was not supported among adult depressed patients, (ii) findings were inconsistent in adult bipolar patients, (iii) for inpatients/outpatients with various psychiatric disorders/conditions, association was observed in adulthood but not in childhood/adolescence. LIMITATIONS: Differences in methodology and definition/measurement of irritability limited the comparability of included studies. CONCLUSIONS: Although irritability has been proposed as a promising transdiagnostic factor associated with suicide-related outcomes, the absence of consensus in the definition of irritability (vs anger or reactive/impulsive aggression), the poor methodological quality, and the lack of developmental considerations mitigate the conclusions.
BACKGROUND:Irritability is gaining considerable attention as a risk factor for suicide-related outcomes (suicide mortality, attempt, and ideation). However, the evidence of this association is scant. We conducted a systematic review of the evidence regarding the associations between irritability and suicide-related outcomes across the life-course. METHODS: We conducted a systematic search on Medline and PsycINFO (up to January 2018) for original articles published in English investigating the association between irritability and suicide-related outcomes. Two researchers independently screened the articles, assessed the quality of the evidence (New-Castle-Ottawa Scale) and extracted study characteristics. RESULTS: Thirty-nine studies were retrieved, most were of low/medium quality. Twelve assessed irritability in childhood/adolescence (6 in community samples, 6 in clinical samples) and 27 in adulthood (7 in community samples, 20 in clinical samples). In both childhood/adolescence and adult samples, most community-based studies reported a positive association between irritability and suicidal ideation and/or attempt, while clinical studies reported mixed findings. More specifically, in clinical studies, the association of irritability with suicide-related outcomes (i) was not supported among adult depressedpatients, (ii) findings were inconsistent in adult bipolarpatients, (iii) for inpatients/outpatients with various psychiatric disorders/conditions, association was observed in adulthood but not in childhood/adolescence. LIMITATIONS: Differences in methodology and definition/measurement of irritability limited the comparability of included studies. CONCLUSIONS: Although irritability has been proposed as a promising transdiagnostic factor associated with suicide-related outcomes, the absence of consensus in the definition of irritability (vs anger or reactive/impulsive aggression), the poor methodological quality, and the lack of developmental considerations mitigate the conclusions.
Authors: Alberto Forte; Massimiliano Orri; Cédric Galera; Maurizio Pompili; Gustavo Turecki; Michel Boivin; Richard E Tremblay; Sylvana M Côté Journal: Eur Child Adolesc Psychiatry Date: 2019-04-25 Impact factor: 4.785
Authors: Massimiliano Orri; Michel Boivin; Chelsea Chen; Marilyn N Ahun; Marie-Claude Geoffroy; Isabelle Ouellet-Morin; Richard E Tremblay; Sylvana M Côté Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2020-11-13 Impact factor: 4.328
Authors: Raffaella Calati; Charles B Nemeroff; Jorge Lopez-Castroman; Lisa J Cohen; Igor Galynker Journal: Int J Neuropsychopharmacol Date: 2020-04-21 Impact factor: 5.176