Katharina Leithner-Dziubas

Lithium in drinking water and suicide mortality

BACKGROUND There is some evidence that natural levels of lithium in drinking water may have a protective effect on suicide mortality. AIMS To evaluate the association between local lithium levels in drinking water and suicide mortality at district level in Austria. METHOD A nationwide sample of 6460 lithium measurements was examined for association with suicide rates per 100,000 population and suicide standardised mortality ratios across all 99 Austrian districts. Multivariate regression models were adjusted for well-known socioeconomic factors known to influence suicide mortality in Austria (population density, per capita income, proportion of Roman Catholics, as well as the availability of mental health service providers). Sensitivity analyses and weighted least squares regression were used to challenge the robustness of the results. RESULTS The overall suicide rate (R(2) = 0.15, β = -0.39, t = -4.14, P = 0.000073) as well as the suicide mortality ratio (R(2) = 0.17, β = -0.41, t = -4.38, P = 0.000030) were inversely associated with lithium levels in drinking water and remained significant after sensitivity analyses and adjustment for socioeconomic factors. CONCLUSIONS In replicating and extending previous results, this study provides strong evidence that geographic regions with higher natural lithium concentrations in drinking water are associated with lower suicide mortality rates.

Validation of the SWAP-200 for diagnosing psychostructural organization in personality disorders

Background: The aim of the study was to investigate the validity of the prototype-matching, empirically based 200-item Shedler-Westen Assessment Procedure (SWAP-200) and its clinical utility for describing underlying dimensions of psychostructural organization and functioning. Sampling and Methods: Patients (n = 306) from two psychoanalytic out-patient departments were included. Replicatory and exploratory factor analysis, correlation and discriminant validity statistics, and canonical correlation analysis were performed. Results: Replicatory factor analysis failed to reproduce the identical original factorial structure. Standard factor analysis revealed an eight-factor solution displaying a dimensional description of psychostructural personality organization (high functioning – neurotic/inhibited – borderline/emotionally dysregulated – psychotic/dissocial). Discriminant validity exists across the sample owing to high/poor psychological functioning. Canonical correlation analysis does not support the replacement of the Structured Clinical Interview for DSM-IV, but provides relevant implications for refining DSM-IV axis II. Conclusions: Support is given for the SWAP instrument in describing dimensional higher-order personality organization and psychostructural functioning.

Personality organization in borderline patients with a history of suicide attempts

Suicide attempts (SA) are common in patients with Borderline Personality Disorder (BPD). Recent studies focus on aspects of personality associated with risk for SA such as deficits in affect regulation including impulse control and aggression. The current study examines associations of dysfunctional personality organization, psychiatric comorbidities as well as non-suicidal self-injury (NSSI) with SA in a sample of 68 BPD outpatients. Patients with a history of SA yielded higher scores in personality domains of aggression, especially self-directed aggression. Further, a history of SA was associated with a worse general level of personality organization and a higher prevalence rate of NSSI and substance abuse disorder. The results demonstrate that SA in BPD patients might be regarded as a manifestation of impaired personality functioning rather than mere state variables and symptoms. Moreover, these findings might have implications for indication, treatment, and prognosis of Borderline Personality Disorder.

Psychotherapie im Krankenhaus

Ein Spital mit Schwerpunkt in der Akutversorgung, wie das AKH Wien, ist gekennzeichnet durch die primare Ausrichtung auf die somatische Versorgung, wobei im Durchschnitt eher eine kurze Aufnahmedauer die Regel ist. Die Indikation fur eine stationare Psychotherapie orientiert sich am Konzept der mehrdimensionalen Genese psychiatrischer Erkrankungen. Psychotherapie ist in der Regel Teil eines mehrdimensionalen Therapieansatzes (Kombination mit Psychopharmakotherapie und soziotherapeutischen Masnahmen).

AS33-01 - Natural lithium in drinking water and suicide mortality

Background There is evidence that natural levels of lithium in drinking water may have a protective effect on suicide mortality. Aims To evaluate the association between local lithium levels in drinking water and suicide mortality in Austria. Method A nationwide sample of lithium measurements was examined for association with suicide rates across Austrian districts. Multivariate regression models were adjusted for socioeconomic factors. Sensitivity analyses and weighted least squares regression were used to challenge the robustness of the results. Results The overall suicide rate as well as the suicide mortality ratio were inversely associated with lithium levels in drinking water and remained significant after sensitivity analyses and adjustment for socioeconomic factors. Conclusions In replicating and extending previous results, this study provides strong evidence that geographic regions with higher natural lithium concentrations in drinking water are associated with lower suicide mortality rates.