Startseite Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
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Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia

  • Suzana Tosic Golubovic EMAIL logo , Olivera Zikic , Gordana Nikolic , Jelena Kostic , Maja Simonovic , Iva Binic und Uros Gugleta
Veröffentlicht/Copyright: 7. Juni 2022
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Aus der Zeitschrift Open Medicine Band 17 Heft 1

Abstract

Individuals with serious mental illness are more affected by emotional reactions, including suicidal behavior due to COVID‐19 and psychosocial consequences of pandemic. The current cross-sectional study aimed to explore the possible association of COVID-19 and suicidal behavior (suicide ideation and attempt) before and during pandemic-associated lockdown in Serbia. We retrospectively reviewed the clinical records of 104 adult psychiatric inpatients admitted at Psychiatric Clinic, University Clinic Center Niš, Serbia, after ending lockdown and compared the obtained results with 181 adult psychiatric inpatients admitted during the same period in 2019 and 2018. Suicide ideation were more frequent in 2020 comparing with 2019 and 2018 (25 vs 12.5%, vs 9.41%; p < 0.05). Around 28% of patients with suicide attempts were exposed daily to the information related to COVID-19 coming from social media, while this frequency was significantly lower, only 7.55% (p < 0.1), among patients with no suicide ideation or attempts. Adjustment disorder was more frequent among patients with suicide attempts in comparison to the patients with suicide ideation (32 vs 11%), especially in patients without suicide ideation and attempts (32 vs 0%, p < 0.001). Of all studied patients with suicide attempts during 2020, 60% were not in the previous psychiatric treatment before admission.

Keywords: suicidal ideation; suicide attempt; COVID-19; hospital admission

1 Introduction

The first case of COVID-19 in the Republic of Serbia was confirmed on March 6, 2020. The Serbian government declared a nationwide state of emergency, in response to the growing pandemic of COVID-19 in the country, on March 15, and between March 18 and May 7, 2020, the government imposed a nationwide lockdown restricting the movement of the population, except for certified needs such as work and health circumstances [1]. Individuals with serious mental illness were adversely affected by the COVID-19 epidemic. This vulnerable population is more affected by the emotional reactions to COVID-19 prevention measures, such as outbreak isolation and quarantine, resulting in fear and anxiety development and thereby increasing diseases related to stress and at the same time causing the exacerbation of preexisting mental disorders in certain individuals [2]. As a result, apart from anxiety and depression, these individuals may experience feelings such as loneliness, denial, insomnia‚ hopelessness, which may decrease their compliance with the treatment. Anxiety, fear of death, fear of losing the loved ones, loss of social connectedness, loss of employment, and homelessness are some of the social stressors that may even trigger serious mental illnesses such as depression and/or anxiety in previously healthy persons and likewise contribute to add burden to mentally ill ones. Patients receiving outpatient treatment due to serious mental illness had difficulties maintaining their regular psychiatric visits for evaluation, treatment, prescriptions, and obtaining regular medication during the lockdown. All of the aforementioned problems may lead to the expected treatment nonadherence and worsened previous mental health symptoms. Similarly, it has been suggested that psychiatric hospitals should reduce their outpatient treatment, tighten admission criteria, and shorten the length of hospital stay worldwide and in Serbia [1]. Therefore, precautions taken as a response to the outbreak could have caused relapses and behavioral changes such as hyperactivity, agitation, and self-harm [3].

Suicide risk is impacted by many different psychiatric, psychological, social, and relational factors, and the impact of the pandemic on vulnerable individuals may have led to an increased suicide risk [4]. Therefore, these preventive measures that also increase the risk of suicide and negative emotions can lead to a decrease in the well-being of individuals with serious mental illness [5]. The impact of COVID-19 pandemic on mental health might be profound, and there are suggestions that suicide rates will increase, although this scenario is not inevitable [4]. Suicide is likely to become a more pressing concern as the pandemic spreads and has long-term effects on the general population, and vulnerable groups. Preventing suicide therefore needs urgent consideration [6].

Taking into account that COVID-19 pandemic and lockdown are associated with an increase in the risk factors for several mental health conditions and that many of these are also risk factors for suicide ideation and attempt, in the present study, we tried to evaluate whether the frequency of suicide ideation and suicide attempts differed in psychiatric hospital admissions before and during the COVID-19 pandemic and lockdown restrictions. Also, we evaluated whether patients differed in terms of sociodemographic data, diagnosis at hospital discharge, number of previous hospitalizations, reasons of admission, period of illness duration, and characteristics of the previous suicide attempts.

2 Methods

In this study, we performed a retrospective review of the clinical records from 104 adult psychiatric inpatients admitted at Psychiatric Clinic, University Clinic Center Niš, Serbia, from May 2020 to August 2020. This was the period after the end of the lockdown in Serbia on May 7, 2020. To compare the obtained results, we also reviewed the clinical records from 181 adult psychiatric inpatients admitted at the same clinic from May 2019 to August 2019 and the same period during 2018.

Inclusion criteria were adult inpatients aged ≥18 years hospitalized to the clinic during the mentioned period of time, and psychiatric diagnosis based on International Classification of Diseases 10th Revision (ICD X), edition 16. Exclusion criteria included the presence of dementia at admission. We prepared, following the study’s main objectives, an ad hoc checklist to gather the principal characteristic of the sample. The following variables were collected from clinical records: sociodemographic data (age, sex, marital status, having children, education, and employment), as well as clinical characteristics (diagnosis based on ICD X at hospital discharge, number of hospital admissions, period of illness evolution, and reason for the last hospital admission). Also, the presence of suicide attempt a minimum 1 year before actual hospitalization, the presence of suicide ideation, the presence of suicide attempt as a reason for the last hospital admission, and type of suicide attempt (intoxication, strangulation, jumping from height, using knife or sharp object, and other ways) were traced in the records. The diagnoses, which were present among the total sample, according to ICD X were as follows: F23-Brief psychotic disorder, F20-Schizophrenia, F25.0- Schizoaffective disorders bipolar type, F25.1-Schizoaffective disorder, depressive type, F31.1-Bipolar disorder, current episode manic, F31.3-Bipolar disorder, current episode depressed, F32-Depressive episode, F33-Major depressive disorder, recurrent, F60-Personality disorders, F43.2-Adjustment disorder, F22-Delusional disorders, F70-Intellectual disabilities, and F06-Other mental disorders due to known physiological condition.

A suicide attempt is defined as a nonfatal, self-directed, potentially injurious behavior with an implicit or explicit intent to die. The behavior may or may not result in injury, and the intensity may vary, but the decision to act out the lethal intent must be present [7].

Furthermore, according to the definition of suicide ideation adopted by Posner et al. [8], it is thoughts about wish to be dead or active thoughts of wanting to end one’s life. A trained psychiatrist assessed suicide ideation when the patient arrived at the emergency department and on admission to the psychiatric ward. Informed consent has been obtained only from individuals hospitalized at 2020. The rest of the collected data was from clinical records of admissions in 2019 and 2018. The research related to human use has been complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and the study has been approved by the authors’ institutional review board or equivalent committee (num. 38788/7).

We tried to evaluate the possible impact of COVID-19-related stress, regarding psycho-socio-behavior factors such as exposure to COVID-19 information on social media, experienced fear of contamination, and adherence to protective measures (wearing a protective mask out of home) on suicidal behavior (suicide attempt or suicide ideation) among subjects admitted at our clinic during 2020. The level of exposure to information about COVID-19 was evaluated by using four options: every day, once or twice per week, once or twice per month, and without information. The fear of being contaminated was evaluated by using three options: often (once or twice per week), rarely (once or twice per month), and without fear of contamination. The adherence to protective measures (wearing a protective mask out of home) was evaluated using three options: permanently, occasionally, and never wearing a mask.

  1. Ethical approval: All listed authors have agreed with the submitted manuscript and have given the corresponding author the authority to act on their behalf in all matters pertaining to publication.

3 Statistical analysis

The analysis of the collected data was performed in IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. The Chi-square test was used to compare the differences in the relative frequencies of different categories, and Z test for proportions was used in pairwise comparison of frequencies. The Kruskal-Wallis test as the nonparametric test was used to compare average values of age as the only continuous variable, since the Kolmogorov Smirnov test confirmed significant deviation from a normal distribution.

4 Results

The total number of patients recruited and their characteristics are presented in Table 1. The first group represents patients with hospital admissions in 2020, while other two groups were patients hospitalized in 2019 and 2018. The results showed that suicide ideation was significantly increased (p < 0.05) in 2020, when compared to the data from 2019 and 2018 (Table 1). Even the suicide attempts, as a reason for hospital admissions, were increased during 2020, compared to the data from 2019 and 2018, and significant differences were not detected.

Table 1

Sociodemographic and clinical characteristics of the study groups

Year Total Chi square Sig.
2018 2019 2020
Group Without suicide ideation/attempt 61 (71.76%) 69 (71.88%) 53 (50.96%) 183 (63.54%) 14.547 0.006
Suicide ideation 8 (9.41%) 12 (12.5%) 26 (25%) 46 (17.01%)
Suicide attempt 16 (18.82%) 15 (15.63%) 25 (24.04%) 56 (19.44%)
Sex a – Female 31 (36.47%) 41 (42.71%) 46 (44.66%) 118 (41.55%) 1.366 0.505
b – Male 54 (63.53%) 55 (57.29%) 57 (55.34%) 166 (58.45%)
Marital status a – Never had been married 33 (38.82%) 52 (54.17%) 57 (54.81%) 142 (49.82%) 8.404 0.210
b – Divorced 13 (15.29%) 11 (11.46%) 15 (14.42%) 39 (13.68%)
c – Widow 4 (4.71%) 7 (7.29%) 5 (4.81%) 16 (5.61%)
d – Married 35 (41.18%) 26 (27.08%) 27 (25.96%) 88 (30.88%)
Having children a – Yes 48 (56.47%) 42 (43.75%) 45 (44.12%) 135 (47.7%) 3.746 0.154
b – No 37 (43.53%) 54 (56.25%) 57 (55.88%) 148 (52.3%)
Education a – Primary school 14 (16.67%) 13 (13.54%) 19 (18.27%) 46 (16.2%) 8.247 0.410
b – Secondary school 54 (64.29%) 64 (66.67%) 73 (70.19%) 191 (67.25%)
c – Higher school 4 (4.76%) 1 (1.04%) 3 (2.88%) 8 (2.82%)
d – University 12 (14.29%) 17 (17.71%) 9 (8.65%) 38 (13.38%)
e – Postgraduate study 0 (0%) 1 (1.04%) 0 (0%) 1 (0.35%)
Employment a – Occasional job 1 (1.18%) 2 (2.11%) 4 (3.85%) 7 (2.46%) 7.409 0.285
b – Permanent job 23 (27.06%) 19 (20%) 15 (14.42%) 57 (20.07%)
c – Retired 11 (12.94%) 15 (15.79%) 11 (10.58%) 37 (13.03%)
d – Unemployed 50 (58.82%) 59 (62.11%) 74 (71.15%) 183 (64.44%)
Number of hospital admissions a – 1 48 (56.47%) 51 (53.13%) 58 (55.77%) 157 (55.09%) 6.863 0.738
b – 2 20 (23.53%) 16 (16.67%) 26 (25%) 62 (21.75%)
c – 3 6 (7.06%) 13 (13.54%) 7 (6.73%) 26 (9.12%)
d – 4 7 (8.24%) 9 (9.38%) 6 (5.77%) 22 (7.72%)
e – 5 1 (1.18%) 2 (2.08%) 3 (2.88%) 6 (2.11%)
f – More than 5 3 (3.53%) 5 (5.21%) 4 (3.85%) 12 (4.21%)
Period of illness evolution a – Up to 6 months 23 (27.06%) 16 (16.67%) 26 (25%) 65 (22.81%) 17.707 0.125
b – Up to 1 year 9 (10.59%) 5 (5.21%) 14 (13.46%) 28 (9.82%)
c – Up to 2 years 4 (4.71%) 5 (5.21%) 7 (6.73%) 16 (5.61%)
d – Up to 3 years 3 (3.53%) 10 (10.42%) 6 (5.77%) 19 (6.67%)
e – Up to 4 years 4 (4.71%) 1 (1.04%) 1 (0.96%) 6 (2.11%)
f – Up to 5 years 1 (1.18%) 5 (5.21%) 5 (4.81%) 11 (3.86%)
g – More than 5 years 41 (48.24%) 54 (56.25%) 45 (43.27%) 140 (49.12%)
Reason for last hospital admission a – Discontinuation of previous psychopharmacy treatment 16 (19.28%) 17 (17.71%) 22 (21.15%) 55 (19.43%) 5.296 0.506
b – Irregular psychopharmacy treatment 7 (8.43%) 9 (9.38%) 12 (11.54%) 28 (9.89%)
c – No association with previous psychopharmacy treatment 32 (38.55%) 41 (42.71%) 29 (27.88%) 102 (36.04%)
d – No previous psychopharmacy treatment 28 (33.73%) 29 (30.21%) 41 (39.42%) 98 (34.63%)
Diagnosis at hospital discharge a – F23 13 (15.29%) 10 (10.42%) 13 (12.5%) 36 (12.63%) 43.489 0.009
b – F20 17 (20%) 33 (34.38%) 37 (35.58%) 87 (30.53%)
c – F25.1 2 (2.35%) 1 (1.04%) 1 (0.96%) 4 (1.4%)
c – F25.0 9 (10.59%) 7 (7.29%) 2 (1.92%) 18 (6.32%)
d – F31.3 0 (0%) 4 (4.17%) 2 (1.92%) 6 (2.11%)
d – F31.1 4 (4.71%) 2 (2.08%) 2 (1.92%) 8 (2.81%)
e – F32 4 (4.71%) 3 (3.13%) 1 (0.96%) 8 (2.81%)
f – F33 13 (15.29%) 9 (9.38%) 6 (5.77%) 28 (9.82%)
g – F60 8 (9.41%) 7 (7.29%) 13 (12.5%) 28 (9.82%)
h – F43.2 2 (2.35%) 5 (5.21%) 11 (10.58%) 18 (6.32%)
i – F22.0 2 (2.35%) 5 (5.21%) 8 (7.69%) 15 (5.26%)
j – F70 0 (0%) 4 (4.17%) 0 (0%) 4 (1.4%)
k – F06 11 (12.9%) 6 (6.25%) 8 (7.69%) 25 (8.8%)
Age 45.34 ± 14.06 40.70 ± 14.73 36.67 ± 13.88 40.58 ± 13.88 18.485 0.000

Undernote: ICD X diagnosis codes: F23 – Brief psychotic disorder, F20 – Schizophrenia, F25.0 – Schizoaffective disorders bipolar type, F25.1 – Schizoaffective disorder, depressive type, F31.1 – Bipolar disorder, current episode manic, F31.3 – Bipolar disorder, current episode depressed, F32 – Depressive episode, F33 – Major depressive disorder, recurrent, F60 – Personality disorders, F43.2 – Adjustment disorder, F22 – Delusional disorders, F70 – Intellectual disabilities, F06 – Other mental disorders due to known physiological condition.

As shown in Table 1, the obtained results indicate a significantly lower percentage of admitted patients without suicide ideation and suicide attempt in 2020, compared to the data from 2019 and 2018 (p < 0.01). Conversely, the most frequent diagnosis at discharge, among the total sample of patients, was schizophrenia (F20-ICD X). Also, this diagnosis was markedly frequent in patients admitted in 2020 compared to those admitted in 2018 (p < 0.05), and when compared with 2019 admissions, the frequency was similar and not statistically different. Major depressive disorder, recurrent (F33 ICD X), was significantly lower (p < 0.05) in patients from 2020 compared to the patients from 2018, while no significant difference was obtained when compared with patients from 2019.

Schizoaffective disorders, bipolar type (F25.0-ICD X), and average age of the patients in 2020 showed significant lower levels (p < 0.05; p < 0.001, respectively) compared with patients from 2019 and 2018. Furthermore, adjustment disorder (F43.2-ICD X) was significantly higher (p < 0.05) among patients in 2020, compared to the patients from 2019 and 2018. The diagnoses of PTSD, as well as addiction disorders, were not present in the total sample. The rest of sociodemographic and clinical characteristics, presented in Table 1, showed no significant differences between the evaluated groups.

Based on the results obtained in our study, patients hospitalized after lockdown in 2020 were divided into three groups, including patients without suicide ideation and suicide attempt, patients with suicide ideation, and patients with suicide attempts. Evaluation of the possible impact of COVID-19-related stress showed that patients with suicide attempts were significantly (p < 0.1) exposed each day to information about COVID-19 in social media, compared to the patients without suicide ideation and attempt (Table 2).

Table 2

Sociodemographic and clinical characteristics of subjects admitted after lockdown in Serbia

Reason for hospital admission Total Chi square Sig.
Without suicide ideation and attempt With suicide ideation With suicide attempt
Exposure to COVID-19 information a – Each day 4 (7.55%) 4 (15.38%) 7 (28%) 15 (14.42%) 10.775 0.096
b – Occasional – once to twice per week 14 (26.42%) 10 (38.46%) 9 (36%) 33 (31.73%)
c – Rear – once to twice per month 18 (33.96%) 6 (23.08%) 7 (28%) 31 (29.81%)
d – No information 17 (32.08%) 6 (23.08%) 2 (8%) 25 (24.04%)
Experienced fear of contamination a – Often – 1–2 days per week 3 (5.66%) 5 (19.23%) 9 (36%) 17 (16.35%) 25.019 0.000
b – Rear – 1–2 days per month 13 (24.53%) 9 (34.62%) 13 (52%) 35 (33.65%)
c – No fear 37 (69.81%) 12 (46.15%) 3 (12%) 52 (50%)
Adherence to protection measures a – Fully complied 4 (7.55%) 8 (30.77%) 4 (16%) 16 (15.38%) 8.143 0.086
b – Occasional 39 (73.58%) 16 (61.54%) 18 (72%) 73 (70.19%)
c – Never 10 (18.87%) 2 (7.69%) 3 (12%) 15 (14.42%)
Sex a – Female 24 (46.15%) 13 (50%) 9 (36%) 46 (44.66%) 1.106 0.575
b – Male 28 (53.85%) 13 (50%) 16 (64%) 57 (55.34%)
Marital status a – Never had been married 37 (69.81%) 10 (38.46%) 10 (40%) 57 (54.81%) 18.527 0.005
b – Divorced 5 (9.43%) 8 (30.77%) 2 (8%) 15 (14.42%)
c – Widow 3 (5.66%) 0 (0%) 2 (8%) 5 (4.81%)
d – Married 8 (15.09%) 8 (30.77%) 11 (44%) 27 (25.96%)
Having children a – Yes 14 (26.92%) 17 (65.38%) 14 (58.33%) 45 (44.12%) 12.973 0.002
b – No 38 (73.08%) 9 (34.62%) 10 (41.67%) 57 (55.88%)
Education a – Primary school 10 (18.87%) 4 (15.38%) 5 (20%) 19 (18.27%) 1.905 0.928
b – Secondary school 37 (69.81%) 20 (76.92%) 16 (64%) 73 (70.19%)
c – Higher school 2 (3.77%) 0 (0%) 1 (4%) 3 (2.88%)
d – University 4 (7.55%) 2 (7.69%) 3 (12%) 9 (8.65%)
Employment a – Occasional job 1 (1.89%) 1 (3.85%) 2 (8%) 4 (3.85%) 13.118 0.041, p < 0.05
b – Permanent job 5 (9.43%) 2 (7.69%) 8 (32%) 15 (14.42%)
c – Retired 5 (9.43%) 2 (7.69%) 4 (16%) 11 (10.58%)
d – Unemployed 42 (79.25%) 21 (80.77%) 11 (44%) 74 (71.15%)
Number of hospital admissions a – 1 29 (54.72%) 13 (50%) 16 (64%) 58 (55.77%) 5.857 0.827
b – 2 13 (24.53%) 6 (23.08%) 7 (28%) 26 (25%)
c – 3 4 (7.55%) 2 (7.69%) 1 (4%) 7 (6.73%)
d – 4 4 (7.55%) 2 (7.69%) 0 (0%) 6 (5.77%)
e – 5 1 (1.89%) 2 (7.69%) 0 (0%) 3 (2.88%)
f – More than 5 2 (3.77%) 1 (3.85%) 1 (4%) 4 (3.85%)
Period of illness evolution a – Up to 6 months 15 (28.3%) 1 (3.85%) 10 (40%) 26 (25%) 17.591 0.129
b – Up to 1 year 4 (7.55%) 6 (23.08%) 4 (16%) 14 (13.46%)
c – Up to 2 years 2 (3.77%) 4 (15.38%) 1 (4%) 7 (6.73%)
d – Up to 3 years 3 (5.66%) 1 (3.85%) 2 (8%) 6 (5.77%)
e – Up to 4 years 1 (1.89%) 0 (0%) 0 (0%) 1 (0.96%)
f – Up to 5 years 3 (5.66%) 1 (3.85%) 1 (4%) 5 (4.81%)
g – More than 5 years 25 (47.17%) 13 (50%) 7 (28%) 45 (43.27%)
Reason for last hospital admission a – Discontinuation of previous psychopharmacy Treatment 13 (24.53%) 6 (23.08%) 3 (12%) 22 (21.15%) 12.721 0.048
b – Irregular psychopharmacy treatment 8 (15.09%) 3 (11.54%) 1 (4%) 12 (11.54%)
c – No association with previous psychopharmacy treatment 11 (20.75%) 12 (46.15%) 6 (24%) 29 (27.88%)
d – No previous psychopharmacy treatment 21 (39.62%) 5 (19.23%) 15 (60%) 41 (39.42%)
Diagnose at hospital discharge a – F23 11 (20.75%) 0 (0%) 2 (8%) 13 (12.5%) 63.739 0.000
b – F20 23 (43.4%) 7 (26.92%) 7 (28%) 37 (35.58%)
c – F25.1 0 (0%) 1 (3.85%) 0 (0%) 1 (0.96%)
c – F25.0 2 (3.77%) 0 (0%) 0 (0%) 2 (1.92%)
d – F31.3 1 (1.89%) 1 (3.85%) 0 (0%) 2 (1.92%)
d – F31.1 2 (3.77%) 0 (0%) 0 (0%) 2 (1.92%)
e – F32 0 (0%) 0 (0%) 1 (4%) 1 (0.96%)
f – F33 0 (0%) 4 (15.38%) 2 (8%) 6 (5.77%)
g – F60 4 (7.55%) 8 (30.77%) 1 (4%) 13 (12.5%)
h – F43.2 0 (0%) 3 (11.54%) 8 (32%) 11 (10.58%)
i – F22.0 8 (15.09%) 0 (0%) 0 (0%) 8 (7.69%)
j – F70 2 (3.77%) 2 (7.69%) 4 (16%) 8 (7.69%)
Age 34.51 ± 12.47 37.12 ± 14.20 40.80 ± 15.87 36.67 ± 13.66 2.478 0.290

Undernote: ICD X diagnosis codes: F23 – Brief psychotic disorder, F20 – Schizophrenia, F25.0 – Schizoaffective disorders bipolar type, F25.1 – Schizoaffective disorder, depressive type, F31.1 – Bipolar disorder, current episode manic, F31.3 – Bipolar disorder, current episode depressed, F32 – Depressive episode, F33 – Major depressive disorder, recurrent, F60 – Personality disorders, F43.2 – Adjustment disorder, F22 – Delusional disorders, F70 – Intellectual disabilities, F06 – Other mental disorders due to known physiological condition.

Often the fear of contamination (1–2 times weekly) was found to be significantly (p < 0.001) increased in patients with suicide attempts, compared to the patients without suicide ideation and attempt. Furthermore, patients with suicide ideation permanently wear a protective mask outside of their homes, significantly more often (p < 0.1) compared to the patients without suicide ideation and attempt (Table 2). The results in Table 2 indicate that patients with suicide ideation show significantly lower (p < 0.05) psychiatric treatment before admission, including psychopharmaceutical treatment, compared to the patients with suicide attempts. Also, significantly lower number of married patients (p < 0.01) and patients with children (p < 0.01) were detected in the group of patients with suicide attempts during 2020, compared to the patients without suicide ideation and attempt. Conversely, the number of unemployed persons was significantly low (p < 0.05) in patients with suicide attempts compared to the patients with suicide ideation. Patients with suicide attempts diagnosed with adjustment disorder (F43.2-ICD X) were significantly higher (p < 0.001) when compared to patients without suicide ideation and attempt. Brief psychotic disorder (F23-ICD X) and delusional disorders (F22-ICD X) were significantly less frequent (p < 0.001) in patients with suicide ideation and the patients with suicide attempts compared to the patients without suicide ideation and attempt.

Major depressive disorder, recurrent (F33-ICD X), in patients with suicide ideation and patients with suicide attempts was significantly higher (p < 0.001) compared with patients without suicide ideation and attempt. Personality disorders (F60-ICD X) in patients with suicide ideation were significantly higher (p < 0.001), compared with patients without suicide ideation and attempt. The rest of sociodemographic and clinical characteristics, presented in Table 2, showed no significant differences between the evaluated groups.

Finally, the data comparison of all patients with suicide attempts regarding the year of admission was performed. The first group includes the patients hospitalized after lockdown in 2020, the second group in 2019, and the third group during 2018 (Table 3).

Table 3

Sociodemographic and clinical characteristics of all study subjects with suicide attempt

Years Total Chi square Sig.
2018 2019 2020
Sex a – Female 8 (50%) 6 (40%) 9 (36%) 23 (41.07%) 0.800 0.670
b – Male 8 (50%) 9 (60%) 16 (64%) 33 (58.93%)
Marital status a – Never had been married 6 (37.5%) 6 (40%) 10 (40%) 22 (39.29%) 7.320 0.292
b – Divorced 1 (6.25%) 1 (6.67%) 2 (8%) 4 (7.14%)
c – Widow 1 (6.25%) 5 (33.33%) 2 (8%) 8 (14.29%)
d – Married 8 (50%) 3 (20%) 11 (44%) 22 (39.29%)
Having children a – Yes 10 (62.5%) 10 (66.67%) 14 (58.33%) 34 (61.82%) 0.276 0.871
b – No 6 (37.5%) 5 (33.33%) 10 (41.67%) 21 (38.18%)
Education a – Primary school 2 (12.5%) 1 (6.67%) 5 (20%) 8 (14.29%) 4.022 0.674
b – Secondary school 8 (50%) 11 (73.33%) 16 (64%) 35 (62.5%)
c – Higher school 2 (12.5%) 1 (6.67%) 1 (4%) 4 (7.14%)
d – University 4 (25%) 2 (13.33%) 3 (12%) 9 (16.07%)
Employment a – Occasional job 0 (0%) 1 (6.67%) 2 (8%) 3 (5.36%) 10.339 0.111
b – Permanent job 1 (6.25%) 4 (26.67%) 8 (32%) 13 (23.21%)
c – Retired 1 (6.25%) 4a (26.67%) 4 (16%) 9 (16.07%)
d – Unemployed 14 (87.5%) 6 (40%) 11 (44%) 31 (55.36%)
Number of hospital admissions a – 1 11 (68.75%) 9 (60%) 16 (64%) 36 (64.29%) 8.101 0.424
b – 2 4 (25%) 2 (13.33%) 7 (28%) 13 (23.21%)
c – 3 0 (0%) 2 (13.33%) 1 (4%) 3 (5.36%)
d – 4 1 (6.25%) 2 (13.33%) 0 (0%) 3 (5.36%)
e – 5 0 (0%) 0 (0%) 1 (4%) 1 (1.79%)
Period of illness duration a – Up to 6 months 6 (37.5%) 3 (20%) 10 (40%) 19 (33.93%) 11.746 0.466
b – Up to 1 year 3 (18.75%) 1 (6.67%) 4 (16%) 8 (14.29%)
c – Up to 2 years 1 (6.25%) 1 (6.67%) 1 (4%) 3 (5.36%)
d – Up to 3 years 0 (0%) 0 (0%) 2 (8%) 2 (3.57%)
e – Up to 4 years 1 (6.25%) 0 (0%) 0 (0%) 1 (1.79%)
f – Up to 5 years 0 (0%) 2 (13.33%) 1 (4%) 3 (5.36%)
g – More than 5 years 5 (31.25%) 8 (53.33%) 7 (28%) 20 (35.71%)
Reason for last hospital admission a – Discontinuation of previous psychopharmacy treatment 3 (18.75%) 2 (13.33%) 3 (12%) 8 (14.29%) 5.350 0.500
b – Irregular psychopharmacy treatment 1 (6.25%) 1 (6.67%) 1 (4%) 3 (5.36%)
c – No association with previous psychopharmacy treatment 6 (37.5%) 8 (53.33%) 6 (24%) 20 (35.71%)
d – No previous psychopharmacy treatment 6 (37.5%) 4 (26.67%) 15 (60%) 25 (44.64%)
Diagnosis at hospital discharge a – F23 1 (6.25%) 0 (0%) 2 (8%) 3 (5.36%) 24.497 0.139
b – F20 3 (18.75%) 3 (20%) 7 (28%) 13 (23.21%)
c – F25.1 2 (12.5%) 0 (0%) 0 (0%) 2 (3.57%)
c – F25.0 0 (0%) 2 (13.33%) 0 (0%) 2 (3.57%)
d – F31.3 3 (18.75%) 2 (13.33%) 1 (4%) 6 (10.71%)
d – F31.1 2 (12.5%) 3 (20%) 2 (8%) 7 (12.5%)
e – F32 2 (12.5%) 1 (6.67%) 1 (4%) 4 (7.14%)
f – F33 0 (0%) 3 (20%) 8 (32%) 11 (19.64%)
g – F60 1 (6.25%) 0 (0%) 0 (0%) 1 (1.79%)
h – F43.2 2 (12.5%) 1 (6.67%) 4 (16%) 7 (12.5%)
Age 44.12 ± 10.62 44.27 ± 16.14 40.80 ± 15.87 42.68 ± 14.49 1.220 0.543
Way of suicide attempt a – Drug intoxication 11 (68.75%) 6 (42.86%) 10 (40%) 27 (49.09%) 7.042 0.532
b – Hanging 1 (6.25%) 2 (14.29%) 4 (16%) 7 (12.73%)
c – Jumping 1 (6.25%) 0 (0%) 2 (8%) 3 (5.45%)
d – Using knife or sharp object 1 (6.25%) 5 (35.71%) 7 (28%) 13 (23.64%)
e – Other 2 (12.5%) 1 (7.14%) 2 (8%) 5 (9.09%)

Undernote: ICD X diagnosis codes: F23 – Brief psychotic disorder, F20 – Schizophrenia, F25.0 – Schizoaffective disorders bipolar type, F25.1 – Schizoaffective disorder, depressive type, F31.1 – Bipolar disorder, current episode manic, F31.3 – Bipolar disorder, current episode depressed, F32 – Depressive episode, F33 – Major depressive disorder, recurrent, F60 – Personality disorders, F43.2 – Adjustment disorder, F22 – Delusional disorders, F70 – Intellectual disabilities, F06 – Other mental disorders due to known physiological condition.

From the total number of patients, 60% who attempted suicide during 2020 never received psychiatric treatment before hospitalization (including psychopharmacy treatment), while this percentage was significantly lower (p < 0.01) during 2019. The frequency of brief psychotic disorder (F23-ICD X) in 2020 was significantly higher (p < 0.001) in patients without suicide ideation and attempt compared to the same diagnoses in patients with suicide attempts and suicide ideation. However, adjustment disorder (F43.2-ICD X) was significantly higher (p < 0.001) in patients with suicide attempts compared to the patients without suicide ideation and patients with suicide attempts (Table 3).

5 Discussion

The ongoing COVID-19 pandemic affects most aspects of society and represents a major psychosocial stressor whose impact on the incidence of mental disorders has already been noted [9,10,11,12]. A recent systematic review has underlined the negative psychological effects of lockdown, including various factors associated with increased suicide risk [13]. Furthermore, several reports have noted that the COVID-19 pandemic and its mitigation policies have led to factors known to precipitate suicide, including social isolation, financial stressors, intensive exposure to stories of hopelessness (through the media), emerging or exacerbated psychological and psychiatric suffering, and other factors [14,15,16,17].

The current cross-sectional study compared patients hospitalized at Psychiatry Clinic Nis, Serbia, 4 months after lockdown in 2020, regarding the frequency of suicide ideation and suicide attempts at psychiatric hospital admission, before and during the lockdown, due to COVID-19 pandemic. In contrast with other research studies [18,19,20,21], which reported a significant drop in psychiatric admissions during the COVID-19 lockdown (i.e., March 1–April 30, 2020), our results reported more hospitalizations during 4 months in 2020, comparing with the same period of time in 2019 and 2018; however, the results were not found to be statistically significant. Gómez-Ramiro et al. [22] showed a significant decrease in the number of psychiatric emergency admissions during the first 3 months of lockdown, compared to the 3 months earlier. Different observation periods and the number of days may explain the differences in the results of various research studies. Moreover, differences with other studies possibly reflect the different organization of the psychiatric units in other countries. It should be noted that we enrolled patients in the period immediately after the end of the national lockdown in Serbia because some urgent hospitalizations were delayed during the lockdown period, per the guideline given by the government.

Despite the early detection of psychological distress in the general population due to the COVID-19 pandemic, its impact on suicidal behavior and mainly on suicidal ideation has not been largely assessed in cross-sectional studies. Our study results indicated that patients with suicidal ideation were significantly more frequent in 2020 compared to the patients in 2019 and 2018. Boldrini et al. [18] reported a 35% increase in suicide ideation in patients during the postlockdown period (i.e., May 1–June 30, 2020), compared to the rates observed in 2018 and 2019. However, that study did not investigate possible differences in suicide attempts.

Suicidal ideation in the general population is a strong predictor of subsequent suicide attempts, and thus, studies have highlighted the importance of its detection in the general population to inform efforts to improve prevention strategies that would adequately address suicide ideation risk and protective factors [23]. Recent meta-analysis across 54 studies suggested increased event rates for suicide ideation, suicide attempts, and self-harm during the COVID-19 pandemic when considered against event rates from prepandemic studies [24]. However, these results are not in agreement with a recent systematic review that did not report an increase in suicide behaviors, suicide attempts, and suicide ideation during the COVID-19 pandemic [25]. Berardelli et al. [26] indicated that only suicide attempts, and not suicide ideation, were more frequent in the psychiatric hospital admission during the COVID-19 pandemic than before. The results of research on the suicide rates during the COVID-19 pandemic are presently inconsistent and reveal that the impact of COVID-19 on suicide rates has not been uniform across countries [27,28,29]. Only a few studies have investigated how epidemics affect suicidality [14,15,30].

Indisputably, the COVID-19 pandemic has influenced suffering among individuals in general [4], and several factors may have influenced suicide attempts in psychiatric patients, including the loss of employment and other factors [16]. Our results are not in line with these studies because the number of unemployed subjects with suicide attempt during 2020 was significantly lower, compared to the almost similar number of subjects with suicide ideation and subjects without suicide ideation and attempts. These findings could be possibly explained by higher distress among employed subjects due to economic repercussion of COVID-19 worldwide and possible job loss.

The average age among patients admitted in 2020 was lower compared to those admitted in 2019 and 2018, suggesting that the younger population was under great distress due to COVID-19 lockdown, quarantine, social distancing, possibility of COVID-19 contamination, and pandemic repercussions on financial and job security. Many young people have had their education interrupted and are anxious about their prospects. Earlier meta-analysis suggested that being younger and female are vulnerability factors for suicide ideation during the COVID-19 pandemic [24].

Preliminary data have suggested that psychiatric patients might experience depression, anxiety, insomnia, and other psychiatric symptoms during the COVID-19 pandemic [10,22,31], while Wang et al. [32] did not find the differences in the mentioned symptoms. In our study, the most frequent psychiatric diagnosis at hospital discharge among the total sample of patients was schizophrenia. This diagnosis was more frequent among patients hospitalized during 2020, compared to patients hospitalized in 2018, while compared to patients hospitalized in 2019, the frequency was near similar, and these findings could be explained with the fact that our institution predominantly treats schizophrenic patients. The diagnosis of adjustment disorder was significantly more frequent among patients hospitalized during 2020, compared to patients in 2019 and 2018, which indicates the importance of psychosocial implications of COVID-19 on subjects, who have never had psychiatry illness and treatment before hospital admission.

Montalbani et al. [33] reported that patients with mental disorders consulted psychiatric services less frequently during the pandemic than before, probably aggravating their emotional and psychological pain. All these factors may contribute to the increased frequency of suicide attempts reported in the present study. Several studies have reported that fear of COVID-19, uncertainty about the future, stigma, and social isolation are significant psychological stressors that may interact to determine psychopathological outcomes, including suicidality [2,13]. Prolonged social isolation during the stay-at-home directives has been associated with the increased loneliness and reduced interpersonal connectedness and social identity, potentially increasing the risk for suicide.

We tried to compare all admissions during the mentioned period in 2020, according to the presence of suicide ideation, attempts, and all other reasons for admission, as well as on questions on sociodemographic, clinical, and variables due to COVID-19, which was not evaluated, according to our knowledge, in previous studies. More than a quarter of patients with suicide attempt each day was exposed to the information in social media about COVID-19, while this frequency was significantly lower among patients with no suicide ideation or attempt. Repeated exposure to the information about the COVID-19 crisis can intensify anxiety, fear, depression, and sleep disorders and heighten the suicide risk [14]. Anxiety and fear of contagion during the COVID-19 crisis may be related to uncertainty, fear of unknown, and panic-inducing stories in traditional and social media [34]. Stressful factors were identified, including quarantine length >10 days, fear of contracting the infection, boredom and frustration for forced inactivity, and fear of shortness of essential elements of survival especially in the case of further prolongation of the institution [13].

Often the fear of being contaminated (1–2 times weekly) reported about one-third of patients with suicide attempts and one-fifth of patients with suicide ideation, while this frequency was significantly lower among patients without suicide ideation or attempt. About a third of patients with suicidal ideation were permanently adherent to protective measures, while this frequency was significantly lower among patients without suicidal ideation and attempt. These results suggested the importance of COVID-19-related behavior, including the presence of fear of being infected, which study subjects reported, on suicidal behavior (suicide ideation and attempts).

The results related to the marital and offspring status in the group of patients with suicidal attempts are not in agreement with the results of Dehara et al. [35], which showed the association between parenthood and lower suicide risk. As we mentioned earlier, employed subjects, married, and those with children might be under more distress due to family responsibility and possible economic repercussions of COVID-19 pandemic worldwide. The presence of fear of losing employment and financial stressors are well-recognized risk factors for suicide [36].

The frequency of the diagnosis of adjustment disorder was higher among patients with suicide attempts compared with patients with suicide ideation and especially among patients without suicidal ideation and attempt, and the difference was significant. As mentioned earlier, these results indicate the importance of psychosocial implications of COVID-19 on subjects, who have never had psychiatric illness and treatment. Acute transitive psychotic disorder and delusional disorders were significantly less frequent (p < 0.001) in patients with suicide ideation and the patients with suicide attempts compared to the patients without suicidal ideation and attempt. Recurrent depression disorder in patients with suicide ideation and patients with suicide attempts was significantly higher (p < 0.001) compared to patients without suicidal ideation and attempt. It is well established that psychiatric disorders, especially with regard to mood disorders, are major contributors to suicidal behaviors [37]. Personality disorder in patients with suicidal ideation was significantly higher (p < 0.001), compared to patients without suicidal ideation and attempt. Ansell et al. [38] highlighted the unique effects of the severity personality disorder predicting suicide attempts over 10 years. The rest of sociodemographic and clinical characteristics, presented in Table 2, showed no significant differences between the evaluated groups. Finally, we tried to compare all patients with suicide attempts, regarding the age of admission. The frequency of psychiatric untreated patients was significantly higher among patients with suicide attempt during 2020 compared to patients with suicide attempt during 2019. The frequency of the diagnosis of adjustment disorder was more frequent among patients with suicide attempts during 2020 compared to patients with suicide attempts during 2019 and especially during 2018, when there were no patients with the mentioned diagnosis, and this difference was found to be significant. These results also indicate the psychosocial importance of COVID-19 on subjects, who have never had psychiatry illness and treatment before hospital admission and developed adjustment disorder due to COVID-19-related stress [39].

6 Limitations

The present study has several limitations. The retrospective design of the study could have led to a certain degree of bias in the collection of some variables. We used the cross-sectional design, and conducting a longitudinal study would be necessary to determine a causal link and long-term effects of the COVID-19 pandemic on suicidal behavior. The small sample size refers to a single psychiatric clinic and may not represent other psychiatric hospitals in Serbia. Moreover, larger multicenter studies must be organized to verify whether these trends may be confirmed in other realities. The psychopathology symptoms severity that led to hospitalization were not quantified using psychometric tools, and the presence of any other psychopathology dimensions that could have affected suicide ideation and suicide attempts should be studied. It was not possible to confirm a link, only the association of COVID-19 pandemic and suicidality, as well as reactions to restrictions (fear of contagion, isolation, and economic problems). Furthermore, the lethality of the suicide attempts during the study period in 2020 was not included in this study.

7 Conclusion

COVID-19 pandemic is a social stress factor that can trigger serious mental disorders among previously mental health individuals, as well as among subjects with previous psychiatric disorders, which might experience worsening symptoms and developing new mental health problems, all associated with the increased suicide risk. Our results demonstrate that were psychiatric admissions at Psychiatric Clinic Nis, Serbia, subjects with suicidal ideation were markedly more frequent, young, employed, patients with children, as well as subjects who have never had psychiatry illness and treatment before hospital admission (including psychopharamacy treatment) were more distressed due to psychosocial and economic repercussion of COVID-19 pandemic. Our results suggested the importance of COVID-19-related behavior, including the presence of fear of being contaminated and adherence to protective measures that study subjects reported, on suicidal behavior (suicide ideation and attempts).

Since studies on previous pandemics have suggested that an increase in psychiatric disorders and suicidal ideations, as a strong predictor of subsequent attempts, as well as suicide attempts may appear months after the epidemic, clinicians should investigate and monitor suicide risk in patients with psychiatric disorders over long periods of time, and it is necessary and important to protect these individuals who are a vulnerable group and provide the health services they need. Suicide prevention in the COVID-19 era is an important and difficult issue. Further research studies are needed to know how mental health consequences can be mitigated during and after the COVID-19 pandemic. Also, it would be interesting to compare the data from similar further studies from Balkan/Mediterranean region because of cultural similarities.

Acknowledgment

We thank all medical doctors in psychiatry residency training at Psychiatry Clinic University of Nis, Serbia, who helped throughout the process of doing this research.

  1. Funding information: The authors state no funding involved.

  2. Authors contributions: STG provided the conceptualization of this study, drafted the manuscript, and performed data analysis. OZ contributed to the study’s design and collection of data. GN, MS, JK, IB, and UG worked on investigation and data collection. OZ conducted the critical revision of the manuscript. All authors read and approved the final manuscript.

  3. Conflict of interest: The authors have no conflicts of interest to declare.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on a reasonable request.

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Received: 2022-03-01
Revised: 2022-04-22
Accepted: 2022-05-04
Published Online: 2022-06-07

© 2022 Suzana Tosic Golubovic et al., published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  47. hsa-miR-340-5p inhibits epithelial–mesenchymal transition in endometriosis by targeting MAP3K2 and inactivating MAPK/ERK signaling
  48. circ_0085296 inhibits the biological functions of trophoblast cells to promote the progression of preeclampsia via the miR-942-5p/THBS2 network
  49. TCD hemodynamics findings in the subacute phase of anterior circulation stroke patients treated with mechanical thrombectomy
  50. Development of a risk-stratification scoring system for predicting risk of breast cancer based on non-alcoholic fatty liver disease, non-alcoholic fatty pancreas disease, and uric acid
  51. Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway
  52. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis
  53. Human amniotic fluid as a source of stem cells
  54. lncRNA NONRATT013819.2 promotes transforming growth factor-β1-induced myofibroblastic transition of hepatic stellate cells by miR24-3p/lox
  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
https://doi.org/10.1515/med-2022-0488
Schlagwörter für diesen Artikel
suicidal ideation; suicide attempt; COVID-19; hospital admission
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. AMBRA1 attenuates the proliferation of uveal melanoma cells
  3. A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma
  4. Differences in complications between hepatitis B-related cirrhosis and alcohol-related cirrhosis
  5. Effect of gestational diabetes mellitus on lipid profile: A systematic review and meta-analysis
  6. Long noncoding RNA NR2F1-AS1 stimulates the tumorigenic behavior of non-small cell lung cancer cells by sponging miR-363-3p to increase SOX4
  7. Promising novel biomarkers and candidate small-molecule drugs for lung adenocarcinoma: Evidence from bioinformatics analysis of high-throughput data
  8. Plasmapheresis: Is it a potential alternative treatment for chronic urticaria?
  9. The biomarkers of key miRNAs and gene targets associated with extranodal NK/T-cell lymphoma
  10. Gene signature to predict prognostic survival of hepatocellular carcinoma
  11. Effects of miRNA-199a-5p on cell proliferation and apoptosis of uterine leiomyoma by targeting MED12
  12. Does diabetes affect paraneoplastic thrombocytosis in colorectal cancer?
  13. Is there any effect on imprinted genes H19, PEG3, and SNRPN during AOA?
  14. Leptin and PCSK9 concentrations are associated with vascular endothelial cytokines in patients with stable coronary heart disease
  15. Pericentric inversion of chromosome 6 and male fertility problems
  16. Staple line reinforcement with nebulized cyanoacrylate glue in laparoscopic sleeve gastrectomy: A propensity score-matched study
  17. Retrospective analysis of crescent score in clinical prognosis of IgA nephropathy
  18. Expression of DNM3 is associated with good outcome in colorectal cancer
  19. Activation of SphK2 contributes to adipocyte-induced EOC cell proliferation
  20. CRRT influences PICCO measurements in febrile critically ill patients
  21. SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis
  22. lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells
  23. circ_AKT3 knockdown suppresses cisplatin resistance in gastric cancer
  24. Prognostic value of nicotinamide N-methyltransferase in human cancers: Evidence from a meta-analysis and database validation
  25. GPC2 deficiency inhibits cell growth and metastasis in colon adenocarcinoma
  26. A pan-cancer analysis of the oncogenic role of Holliday junction recognition protein in human tumors
  27. Radiation increases COL1A1, COL3A1, and COL1A2 expression in breast cancer
  28. Association between preventable risk factors and metabolic syndrome
  29. miR-29c-5p knockdown reduces inflammation and blood–brain barrier disruption by upregulating LRP6
  30. Cardiac contractility modulation ameliorates myocardial metabolic remodeling in a rabbit model of chronic heart failure through activation of AMPK and PPAR-α pathway
  31. Quercitrin protects human bronchial epithelial cells from oxidative damage
  32. Smurf2 suppresses the metastasis of hepatocellular carcinoma via ubiquitin degradation of Smad2
  33. circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury
  34. Sonoclot’s usefulness in prediction of cardiopulmonary arrest prognosis: A proof of concept study
  35. Four drug metabolism-related subgroups of pancreatic adenocarcinoma in prognosis, immune infiltration, and gene mutation
  36. Decreased expression of miR-195 mediated by hypermethylation promotes osteosarcoma
  37. LMO3 promotes proliferation and metastasis of papillary thyroid carcinoma cells by regulating LIMK1-mediated cofilin and the β-catenin pathway
  38. Cx43 upregulation in HUVECs under stretch via TGF-β1 and cytoskeletal network
  39. Evaluation of menstrual irregularities after COVID-19 vaccination: Results of the MECOVAC survey
  40. Histopathologic findings on removed stomach after sleeve gastrectomy. Do they influence the outcome?
  41. Analysis of the expression and prognostic value of MT1-MMP, β1-integrin and YAP1 in glioma
  42. Optimal diagnosis of the skin cancer using a hybrid deep neural network and grasshopper optimization algorithm
  43. miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells
  44. Clinical value of SIRT1 as a prognostic biomarker in esophageal squamous cell carcinoma, a systematic meta-analysis
  45. circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8
  46. miR-22-5p regulates the self-renewal of spermatogonial stem cells by targeting EZH2
  47. hsa-miR-340-5p inhibits epithelial–mesenchymal transition in endometriosis by targeting MAP3K2 and inactivating MAPK/ERK signaling
  48. circ_0085296 inhibits the biological functions of trophoblast cells to promote the progression of preeclampsia via the miR-942-5p/THBS2 network
  49. TCD hemodynamics findings in the subacute phase of anterior circulation stroke patients treated with mechanical thrombectomy
  50. Development of a risk-stratification scoring system for predicting risk of breast cancer based on non-alcoholic fatty liver disease, non-alcoholic fatty pancreas disease, and uric acid
  51. Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway
  52. circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis
  53. Human amniotic fluid as a source of stem cells
  54. lncRNA NONRATT013819.2 promotes transforming growth factor-β1-induced myofibroblastic transition of hepatic stellate cells by miR24-3p/lox
  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
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Heruntergeladen am 3.12.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2022-0488/html
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