The curious effect of an increase of the placebo effect across year of publication has been shown for depression, schizophrenia, obsessive-compulsive disorder, as well as for some medical conditions like hypertension and pain.

We aimed to observe how randomised clinical trials with a placebo control behave at this respect in panic disorder trials.

We searched the PubMed database using the strategy: (panic disorder OR panic attack disorder) AND placebo, which on 3 November 2020 produced 779 records. Inclusion criteria were the above stated, excluded were all studies focusing on the same patients as others and those not providing intelligible data. In our selection we used the PRISMA statement and reached agreement with Delphi rounds.

We identified through other sources further 3 studies. The finally eligible studies were 82, excluded were 700 studies, mainly consisting of reviews (176), challenge studies (173), not dealing with panic disorder (67), studies with unsuitable designs to detect placebo effect (53), studies using same populations as others (36), those with misfocused outcomes (57), those lumping diagnoses and not allowing to separate data for panic disorder (22), and those not using placebo at all (21). Mean response to placebo in included panic disorder studies was 36.01±19.812, ranging from 0 to 76.19%; the correlation with year of publication was positive and significant (Pearson’s r= 0.246; p=0.026).

The effect of placebo in randomised control trials has increased across the years, but this field of research appears to be idle in recent years.

No significant relationships.

Previous researches showed that adolescents are at high risk of suicide. Suicide is a trans-nosographic phenomenon regardless of psychiatric diagnosis. Trauma is an important risk factor for suicide and young help-seeking patients usually refer traumatic experiences, especially during childhood.

The objective of this study is to assess the relationship between traumatic experience and suicide risk comparing adolescents with suicide risk with adolescents without suicide risk.

To investigate correlations between trauma, psychopathology and suicide risk in a sample of young help-seeking outpatients.

We recruited 99 outpatients aged between 14 and 21 years admitted to department for prevention and early intervention in adolescence of Rome. We administered psychometric instruments exploring suicide risk (SHSS, BHS), prodromal (SIPS/SOPS), affective and anxious symptoms (HAM-A, HAM-D,MRS), child abuse (CTQ) and experiences of depersonalization (CDS).

Sample is composed of 31 men and 68 women. A total of 34.3% had mood disorder. A total of 28.3% reported history of emotional neglect, 20.2% emotional abuse, 9.15 sexual abuse, 5.1% physical neglect, 9,1% sexual abuse, 4% physical abuse. More than 30% of patients were at increased suicide risk. Depressive, irritable, anxious and cyclothymic temperament was associated with suicide risk. Patients with suicide risk had higher score at HAM-D (t63 = 2.65; P = 0.01), CDS (t63 = 2.77; P = 0.007), in CTQ (t63 = 3.20; P = 0.002) and BHS (t63 = 3.23; P = 0.002).

Adolescents with suicide risk, compared with those without, reported more frequently early traumatic experiences and psychiatric symptoms. Early traumatic experiences constitute a risk factor for both suicide risk and psychiatric symptoms during adolescence.

The authors have not supplied their declaration of competing interest.

Increased concentrations of kynurenine (KYN) pathway metabolites have been associated to several groups of psychiatric disorders. As for suicide risk literature is still inconclusive due to the limited evidence.

to test the hypothesis of Increased concentrations of kynurenine as related to suicide attempter.

We aim to investigate the association between kynurenine pathway metabolites blood levels and suicidal behaviour, in affective disorder patients, in order to explore if kynurenine pathway metabolites could be potential diagnostic biomarkers.

We enrolled a sample of affective disorder patients and perform detailed diagnoses, as well as detailed assessment of suicidal behaviour using validated questionnaires. We also aim to follow-up individuals included in the current study.

Plasma KYN was assayed by high performance liquid chromatography in three groups: healthy volunteers (n = 90), patients with mood disorders with a recent suicide attempt (n = 44) and without (n = 44) history of suicide attempt. Analysis of variance tested for group differences in KYN levels. Each was evaluated with psychometric scales. Patients were sampled for 10 cc of venous blood for assay. The preparation of blood samples and assay was processed by a specialist using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).

Preliminary results will be presented as to shed light if KYN levels differed across groups. According to preliminary calculations we expect that KYN is higher in suicide attempters compared with non-attempters, who did not differ from healthy volunteers.

Our work-in-progress study suggests that KYN and related molecular pathways may be implicated in the precipitation of suicidal behavior.

The authors have not supplied their declaration of competing interest.