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Suicidal Behavior (suicidal + behavior)

Distribution by Scientific Domains

Medical Sciences	51%
Psychology	36%

Selected Abstracts

Suicidal Behavior in Children Younger than Twelve: A Diagnostic Challenge for Emergency Department Personnel

ACADEMIC EMERGENCY MEDICINE, Issue 9 2007
Carl L. Tishler PhD
Suicide is one of the leading causes of death in children younger than 12 years and is the fourth leading cause of death in 12 year olds. Increasing numbers of young children now present to the emergency department (ED) with mental health issues, and ED personnel must determine the most appropriate disposition options for these children, sometimes without the assistance of specialty mental health services. Much of the present body of literature describing suicidality fails to separate children from adolescents for analysis and discussion. This article reviews relevant literature pertaining to suicidal thoughts and behaviors in young children and discusses problems with available data, as well as epidemiology, risk factors, typical motivations, methods, assessment, and disposition for these patients. Suicidal children younger than 12 years are often clinically different from suicidal adolescents and adults and may require unique assessment and disposition strategies in the ED. A child who has ideation without a clear plan, or has made an attempt of low lethality, can sometimes be discharged home, provided that a supportive, responsible caregiver is willing to monitor the child and take him or her to outpatient mental health appointments. If the home environment is detrimental, or the child has used a method of high potential lethality, inpatient treatment is the most appropriate course of action. Mental health specialty services, when available, should be used to help determine the most appropriate disposition. [source]

The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions

DEPRESSION AND ANXIETY, Issue 9 2010
Josh Nepon M.D.
Abstract Background: Previous work has suggested that anxiety disorders are associated with suicide attempts. However, many studies have been limited by lack of accounting for factors that could influence this relationship, notably personality disorders. This study aims to examine the relationship between anxiety disorders and suicide attempts, accounting for important comorbidities, in a large nationally representative sample. Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2. Face-to-face interviews were conducted with 34,653 adults between 2004 and 2005 in the United States. The relationship between suicide attempts and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, posttraumatic stress disorder (PTSD)) was explored using multivariate regression models controlling for sociodemographics, Axis I and Axis II disorders. Results: Among individuals reporting a lifetime history of suicide attempt, over 70% had an anxiety disorder. Even after adjusting for sociodemographic factors, Axis I and Axis II disorders, the presence of an anxiety disorder was significantly associated with having made a suicide attempt (AOR=1.70, 95% confidence interval (CI): 1.40,2.08). Panic disorder (AOR=1.31, 95% CI: 1.06,1.61) and PTSD (AOR=1.81, 95% CI: 1.45,2.26) were independently associated with suicide attempts in multivariate models. Comorbidity of personality disorders with panic disorder (AOR=5.76, 95% CI: 4.58,7.25) and with PTSD (AOR=6.90, 95% CI: 5.41,8.79) demonstrated much stronger associations with suicide attempts over either disorder alone. Conclusion: Anxiety disorders, especially panic disorder and PTSD, are independently associated with suicide attempts. Clinicians need to assess suicidal behavior among patients presenting with anxiety problems. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source]

Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009
L.-H. Thorell
Objective:, Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model. Method:, A meta-analysis was performed of 279 depressed patients and 59 healthy subjects. Results:, The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P- value ranging from 4.7 × 10,8 to 1.1 × 10,14. Conclusion:, The high discriminative validity and the emerging links over a proposed interest-limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression. [source]

Association between familial suicidal behavior and frequency of attempts among depressed suicide attempters

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009
D. Lizardi
Objective:, Only a few studies have examined whether a family history of suicide influences the severity of suicidal acts and the results have been inconsistent. The current study aimed to examine whether a family history of suicidal acts predicts severity of suicide attempts. Method:, 190 suicide attempters aged 18,75 years with a lifetime history of major depression were assessed for first-degree family history of suicidality and severity of suicide attempts (number and lethality of prior suicide attempts and age at first attempt). Results:, Regression analyses indicate that a positive family history of suicidal behaviors predicts a greater number of suicide attempts. Reasons for living predict number and lethality of prior attempts. Conclusion:, It is critical to assess for family history of suicidal behavior when treating depressed suicide attempters as it may serve as an indicator of the risk of repeat suicide attempt and as a guide for treatment. [source]

Prospective studies of suicidal behavior in major depressive and bipolar disorders: what is the evidence for predictive risk factors?

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2006
M. A. Oquendo
Objective:, Prospective studies over the past 30 years have identified an array of predictive indicators for suicidal acts in mood disorders. However, prediction of suicidal behavior remains an elusive goal. This paper reviewed evidence from prospective studies for clinical factors that elevate risk of suicidal acts in that group. Method:, English language prospective studies of suicidal behavior in major depressive and bipolar disorders were examined. Results:, The predictors with the best support were a past history of suicidal behavior and the presence of refractory or recurrent depressions. For other risk factors, there was either not enough data to consider them robust or findings were contradictory. Conclusion:, Future studies must not only be comprehensive in their inclusion of potentially contributing factors, but must also address their relative importance towards the goal of developing predictive models and enhance suicide prevention efforts. [source]

Psychiatric comorbidity and suicidal behavior in epilepsy: A community-based case,control study

EPILEPSIA, Issue 7 2010
Sabrina Stefanello
Summary Purpose:, To provide information about psychiatric comorbidity and suicidal behavior in people with epilepsy compared to those without epilepsy from a community sample in Brazil. Methods:, An attempt was made to evaluate all 174 subjects with epilepsy (cases) identified in a previous survey. For every case identified, an individual without epilepsy (control) matched by sex and age was selected in the same neighborhood. A structured interview with validated psychiatric scales was performed. One hundred and fifty-three cases and 154 controls were enrolled in the study. Results:, People with epilepsy had anxiety more frequently [39.4% vs. 23.8%, odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2,3.5; p = 0.006], depression (24.4% vs. 14.7%, OR 1.9, 95% CI 1.01,3.5; p = 0.04), and anger (55.6% vs. 39.7%, OR 1.9, 95% CI 1.2,3.1; p = 0.008). They also reported more suicidal thoughts [36.7% vs. 23.8%, OR 1.8, 95% CI 1.1,3.1; p = 0.02), plans (18.2% vs. 3.3%, OR 2.0, 95% CI 1.0,4.0; p = 0.04), and attempts (12.1% vs. 5.3%, OR 2.4, 95% CI 1.1,3.2, p = 0.04) during life than controls. Conclusions:, These findings call attention to psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation, and treatment may improve quality of life in epilepsy and ultimately prevent suicide. [source]

Assessing suicide risk among callers to crisis hotlines: A confirmatory factor analysis,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2010
Tracy K. Witte
Abstract Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow-up than the SDI factor. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1,24, 2010. [source]

Longitudinal relations between employment and depressive symptoms in low-income, suicidal African American women

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2007
Nathan Mascaro
Unemployment and depression are problematic at both individual and societal levels, and research suggests that the two phenomena are related. More thorough and longitudinal analyses, particularly ones within low-income minority populations, are needed to guide the development of programs to increase employment in persons with mental health problems. The current study aimed to specify the relations over time between depressive symptoms and employment status within a sample of 46 low-income African American women participating in an intervention study for intimate partner violence and suicidal behavior. Hierarchical logistic regression analysis indicated that baseline levels of depressive symptoms predicted employment status at the end of a 10-week intervention period, controlling for baseline employment status. Chi-square analysis and qualitative analyses of trends in depression scores showed that changes in employment status during the 10-week intervention period predicted 6-month and one-year follow-up levels of depressive symptoms. Results imply that, for women in the currently sampled population, depressive symptoms create vulnerability for job loss, but the ability to gain employment despite high levels of depressive symptoms is linked to lowered depression levels over the long term. Community programs assisting such women could therefore not just lower the vulnerability to job loss by treating depressive symptoms, but they could potentially lower long-term depression levels through interventions that enhance employability and motivation to pursue work. © 2007 Wiley Periodicals, Inc. J Clin Psychol. [source]

Risk management with suicidal patients

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006
Alan L. Berman
The patient who is at-risk for suicide is complex and is difficult to evaluate and treat effectively. Should suicidal behavior occur, the clinician faces the potential wrath of bereaved survivors and their externalized blame exercised through a malpractice suit. The clinician's duty of care to a patient is to act affirmatively to protect a patient from violent acts against self. A finding of malpractice is established if the court finds that this duty was breached, through an act of omission or commission relative to the standard of care, and that this breach was proximately related to the patient's suicidal behavior. This article discusses the standard of care and factors that determine liability in a suicide death of a patient. An extensive list of recommendations for competent caregiving for the at-risk patient and risk management guidelines are then presented. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 171,184, 2006. [source]

Body Weight Perception, Unhealthy Weight Control Behaviors, and Suicidal Ideation Among Korean Adolescents

JOURNAL OF SCHOOL HEALTH, Issue 12 2009
Dong-Sik Kim DrPH
ABSTRACT BACKGROUND: This study examined the mediating function of body weight perception (BWP) in the relation between body mass index (BMI) and unhealthy weight control behaviors (UWCBs; eg, fasting, using diet pills, or laxatives), and between BMI and suicidal ideation. It also explored the correlation between exposure to multiple UWCBs and suicidal ideation among Korean adolescents. METHODS: Data on BMI, BWP, UWCBs, and suicidal ideation were obtained from the 2006 Korean Youth Risk Behavior Web-based Survey, a school-based survey conducted on a nationally representative sample of students in grades 7,12 (36,463 boys and 33,433 girls). Data were analyzed using bivariate and multivariate logistic regression. RESULTS: BMI was significantly associated with both UWCB and suicidal ideation among boys and girls, even after controlling for covariates. However, the significance and magnitude of the association between BMI and UWCB were considerably attenuated when BWP was added to the model. When BWP was included, the association between overweight BMI status and suicidal ideation became nonsignificant in both sexes, whereas the association between underweight BMI status and suicidal ideation remained significant among boys. Adolescent boys and girls engaging in multiple UWCBs were at greater risk for experiencing suicidal thoughts. CONCLUSIONS: This study suggests that BWP represents a potential mediator between BMI and UWCB, and between BMI and suicidal ideation among both boys and girls. Thus, school programs addressing issues related to BWP should be developed and targeted at adolescents to reduce the potential risks for both UWCB and suicidal behavior. [source]

Suicide risk factors and mediators between childhood sexual abuse and suicide ideation among male and female suicide attempters,

JOURNAL OF TRAUMATIC STRESS, Issue 5 2009
Megan Spokas
The current study examined the manner in which childhood sexual abuse (CSA) history relates to risk factors for suicidal behavior among recent suicide attempters (n = 166). Men who recently attempted suicide and endorsed a CSA history had higher scores on measures of hopelessness and suicide ideation than men without a CSA history. Men with a CSA history were also more likely to have made multiple suicide attempts and meet diagnostic criteria for posttraumatic stress disorder and borderline personality disorder. In contrast, there were fewer group differences as a function of CSA history among the female suicide attempters. Hopelessness was a significant mediator between CSA history and suicide ideation in both men and women. [source]

Suicidal disorders: A nosological entity per se?

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 1 2005
Marion Leboyer
Abstract An extensive body of data has repeatedly shown in the past decades that suicidal behaviors are associated with several external validators such as low serotonergic activity in body fluids and in brains of suicide victims, genetic transmission of suicide risk independently of transmission of associated major psychiatric disorders, and more recently association with several serotonin-related genes. Despite these concordant findings, suicidal behaviors are still not considered as a nosological entity per se in standardized classification. The aim of this study is to review the existing literature establishing the validity of this entity through clinical, genetic, biochemical, and therapeutic arguments all leading to the need to recognizing suicidal behavior as an independent and possibly dimensional clinical entity. © 2005 Wiley-Liss, Inc. [source]

Serotonin transporter gene polymorphism and psychiatric disorders in NF1 patients

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 8 2001
Frank Bellivier
Abstract Neurofibromatosis type 1 (NF1) is an autosomal-dominant genetic disease characterized by a broad clinical expression. Comorbid affective disorders, anxiety disorders, and suicide are frequently observed during NF1. The promoter marker (5-HTTLPR) of the serotonin transporter gene (5-HTT) has been shown to be associated with major affective disorders, anxiety-related trait, and more recently with suicidal behavior. This gene is adjacent to the NF1 gene, raising the question of the implication of the 5-HTT gene in the psychiatric comorbidity during NF1. Eighty-eight patients with NF1 and 184 screened controls were typed for the 5-HTTLPR. No deviation from the Hardy-Weinberg equilibrium in patients was observed. In addition, allele and genotype frequencies were similar in the two groups. Our data do not support the implication of the 5-HTT gene in the psychiatric comorbidities of NF1. © 2001 Wiley-Liss, Inc. [source]

Caught in the trio trap?

AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 4 2001
Potential selection bias inherent to association studies usings parent-offspring trios
Abstract During the last years, the validity of classic case control studies in psychiatric genetic research has been increasingly under question due to the risk of population stratification problems inherent to this type of association study. By consequence, the application of family-based association studies using parent-offspring trios has been strongly advocated. Recently, however, in a study comparing clinical characteristics between index patients from parent-offspring trios and singleton patients with bipolar affective disorder, the question was raised whether a systematic neglect of case control association studies could lead to a selection bias of susceptibility genes. In a similar approach, we compared demographic and clinical characteristics of 122 singleton bipolar patients with those of 54 bipolar patients derived from parent-offspring trios. The singleton patients did not only present with a higher age of onset, but also with a higher frequency of suicidal behavior and a higher familial loading for suicidality. These findings suggest that the genetic mechanism for disease might be different between trio-based and classic case control samples, where patients are examined whose parents are not available for genetic studies. Thus, giving up case control designs for the sake of family-based association studies could be at the risk of selecting against several genetically determined factors. © 2001 Wiley-Liss, Inc. [source]

Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2009
Lynsay Ayer
Background:, The Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) profile and Posttraumatic Stress Problems (CBCL-PTSP) scale have been used to assess juvenile bipolar disorder (JBD) and posttraumatic stress disorder (PTSD), respectively. However, their validity is questionable according to previous research. Both measures are associated with severe psychopathology often encompassing multiple DSM-IV diagnoses. Further, children who score highly on one of these scales often have elevated scores on the other, independent of PTSD or JBD diagnoses. We hypothesized that the two scales may be indicators of a single syndrome related to dysregulated mood, attention, and behavior. We aimed to describe and identify the overlap between the CBCL-JBD profile and CBCL-PTSP scales. Method:, Two thousand and twenty-nine (2029) children from a nationally representative sample (1073 boys, 956 girls; mean age = 11.98; age range = 6,18) were rated on emotional and behavior problems by their parents using the CBCL. Comparative model testing via structural equation modeling was conducted to determine whether the CBCL-JBD profile and CBCL-PTSP scale are best described as measuring separate versus unitary constructs. Associations with suicidality and competency scores were also examined. Results:, The CBCL-JBD and CBCL-PTSP demonstrated a high degree of overlap (r = .89) at the latent variable level. The best fitting, most parsimonious model was one in which the CBCL-JBD and CBCL-PTSP items identified a single latent construct, which was associated with higher parental endorsement of child suicidal behavior, and lower functioning. Conclusions:, The CBCL-JBD profile and CBCL-PTSP scale overlap to a remarkable degree, and may be best described as measures of a single syndrome. This syndrome appears to be related to severe psychopathology, but may not conform to traditional DSM-IV classification. These results contribute to the ongoing debate about the utility of the CBCL-JBD and CBCL-PTSP profiles, and offer promising methods of empirically based measurement of disordered self-regulation in youth. [source]

Cigarette smoking is associated with suicidality in bipolar disorder

BIPOLAR DISORDERS, Issue 7 2009
Michael J Ostacher
Objectives:, Cigarette smoking in individuals with bipolar disorder has been associated with suicidal behavior, although the precise relationship between the two remains unclear. Methods:, In this prospective observational study of 116 individuals with bipolar disorder, we examined the association between smoking and suicidality as measured by Linehan's Suicide Behaviors Questionnaire (SBQ) and prospective suicide attempts over a nine-month period. Impulsivity was measured by the Barratt Impulsiveness Scale. Results:, Smoking was associated with higher baseline SBQ scores in univariate and adjusted analyses, but was not significant after statistical adjustment for impulsivity in a regression model. A higher proportion of smokers at baseline made a suicide attempt during the follow-up period (5/31, 16.1%) compared to nonsmokers (3/85, 3.5%); p = 0.031, odds ratio = 5.25 (95% confidence interval: 1.2,23.5). Smoking at baseline also significantly predicted higher SBQ score at nine months. Conclusions:, In this study, current cigarette smoking was a predictor of current and nine-month suicidal ideation and behavior in bipolar disorder, and it is likely that impulsivity accounts for some of this relationship. [source]

A critical appraisal of lithium's efficacy and effectiveness: the last 60 years

BIPOLAR DISORDERS, Issue 2009
Paul Grof
The history that depicts the evaluation of lithium's efficacy presents an interesting contrast: on the one hand, conviction that, of all psychotropic drugs, lithium has the best demonstrated efficacy; on the other hand, repeated attempts to question it. Those contesting lithium's stabilizing abilities have argued from several angles, for example that the proof was methodologically incorrect or insufficient, that the number of responders is small, or that the response is poor in practice and does not last. But there is a good explanation for this paradox. While the early challenges to lithium's value in recurrent mood disorders reflected mainly that psychiatry had not yet developed a methodology suitable for testing long-term efficacy, more recent questioning has resulted mostly from retesting its efficacy and effectiveness in a substantially broadened bipolar spectrum, outside the classical diagnosis. Lithium, however, continues to stabilize very well the patients suffering from typical bipolar disorder,the condition for which its efficacy was originally demonstrated. More recently, lithium has also proven to dramatically reduce suicidal behavior and mortality and to augment markedly the efficacy of antidepressants in unresponsive patients. [source]

Association between brain-derived neurotrophic factor gene and a severe form of bipolar disorder, but no interaction with the serotonin transporter gene

BIPOLAR DISORDERS, Issue 5 2008
Ilona Vincze
Background:, Recent data suggest that brain-derived neurotrophic factor (BDNF) and the serotonergic system are involved and interact in major depressive disorder and suicidal behavior (SB). Several family and population-based studies have reported associations between the BDNF gene and serotonin-related genes, specifically the serotonin transporter (5HTT) gene, with bipolar disorder (BD) and SB. However, despite the fact that gene-by-gene interaction between BDNF and 5HTT has been demonstrated in monoamine deficiencies in animals, this kind of interaction has never been tested in humans. Our hypothesis is that some BDNF and 5HTT polymorphisms might confer increased risk for BD and SB and that both genes may interact with each other. Methods:, To test this hypothesis, we genotyped the most common BDNF polymorphisms, G196A (Val66Met), A-633T and BDNF-LCPR, as well as 5HTT (5HTT-LPR), in 447 BD patients and 370 controls. Results:, We replicated the association previously reported between BDNF G196A (Val66Met) polymorphism and BD. We also observed a correlation between the number of G196 alleles and short alleles of 5HTT-LPR and the severity of SB in BD. However, we found no significant interaction between these two markers. Conclusions:, These results suggest that BDNF G196A as well as 5HTT-LPR polymorphisms confer risk for SB in BD, but we did not observe any evidence for an interaction between them. [source]

Manic symptoms and impulsivity during bipolar depressive episodes

BIPOLAR DISORDERS, Issue 3 2007
Alan C Swann
Objectives:, In contrast to the extensive literature on the frequent occurrence of depressive symptoms in manic patients, there is little information about manic symptoms in bipolar depressions. Impulsivity is a prominent component of the manic syndrome, so manic features during depressive syndromes may be associated with impulsivity and its consequences, including increased risk of substance abuse and suicidal behavior. Therefore, we investigated the prevalence of manic symptoms and their relationships to impulsivity and clinical characteristics in patients with bipolar depressive episodes. Methods:, In 56 bipolar I or II depressed subjects, we investigated the presence of manic symptoms, using Mania Rating Scale (MRS) scores from the Schedule for Affective Disorders and Schizophrenia (SADS), and examined its association with other psychiatric symptoms (depression, anxiety, and psychosis), age of onset, history of alcohol and/or other substance abuse and of suicidal behavior, and measures of impulsivity. Results:, MRS ranged from 0 to 29 (25th,75th percentile, range 4,13), and correlated significantly with anxiety and psychosis, but not with depression, suggesting the superimposition of a separate psychopathological mechanism. Impulsivity and history of substance abuse, head trauma, or suicide attempt increased with increasing MRS. Receiver-operating curve analysis showed that MRS could divide patients into two groups based on history of alcohol abuse and suicide attempt, with an inflection point corresponding to an MRS score of 6. Discussion:, Even modest manic symptoms during bipolar depressive episodes were associated with greater impulsivity, and with histories of alcohol abuse and suicide attempts. Manic symptoms during depressive episodes suggest the presence of a potentially dangerous combination of depression and impulsivity. [source]

Association between familial suicidal behavior and frequency of attempts among depressed suicide attempters

Factors associated with suicidal behaviors in a large French sample of inpatients with eating disorders

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 7 2007
Valérie J. Fedorowicz MDCM
Abstract Objective: The objective of the present study was to identify factors associated with suicidal behaviors among patients with eating disorders. Method: A large database including sociodemographic and clinical characteristics of 1,009 consecutive patients hospitalized for an eating disorder in Paris, France, was examined. Data gathered upon admission to hospital were analyzed to identify factors associated with a history of suicide attempt or current suicidal ideation, among the whole sample as well as among each subtype of eating disorder. Results: Among the whole sample, the factor most strongly associated with suicide attempt or suicidal ideation was the diagnostic category, with the highest odds ratio for bulimia nervosa followed by anorexia nervosa of the binging/purging subtype. Among diagnostic subgroups, the strongest factors were drug use, alcohol use, and tobacco use. Conclusion: Suicide risk should be monitored carefully among patients with eating disorders, paying particular attention to combinations of risk factors. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source]

Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2009
Kelly E. Grover
Abstract The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.© 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,10, 2009. [source]

Conducting suicide research in naturalistic clinical settings,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2009
David A. Jobes
Abstract Unique challenges arise for clinical researchers designing studies focused on suicidal behaviors due to the inherently high-risk nature of such research. Traditional approaches to clinical trial design are briefly discussed, highlighting the limitations and obstacles of these approaches when working with suicidal individuals. Using their own personal experiences and setbacks from an ongoing clinical suicidology research program, the authors argue for greater emphasis on effectiveness and translational research designs conducted in naturalistic clinical settings to test the practical utility of empirically-supported treatments for suicidal behaviors, to gain new perspectives on suicidal individuals, and to better understand the nature of suicidal risk. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,14, 2009. [source]

Psychosocial treatments of suicidal behaviors: A practice-friendly review

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006
Katherine Anne Comtois
Worldwide, almost a million people die by suicide each year. Intentional, nonfatal, self-inflicted injury, including both suicide attempts and acts without suicide intent, also has very high prevalence. This article provides a practice-friendly review of controlled studies of psychosocial treatments aiming to prevent suicide, attempted suicide, and nonsuicidal self-inflicted injuries. Despite relatively small sample sizes for a low-base-rate outcome such as self-inflicted injury, several psychotherapies have been found effective, including cognitive therapy, dialectical behavior therapy, problem-solving therapy, and interpersonal psychotherapy, as well as outreach interventions, such as sending caring letters. The clinical implications of the review are discussed with the goal of translating the science to service,particularly the importance of outreach and treatment of non-compliance, the assessment and management of suicide risk, and competency in effective psychotherapies. These are critical steps for clinical psychology and psychotherapists to take in their role in suicide prevention. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 161,170, 2006. [source]

Suicide risk during anticonvulsant treatment,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2010
Maurizio Pompili MD
Abstract Recent research findings suggest possible increases in risk of suicidal behaviors among patients treated with anticonvulsants. The available evidence appears to support such a risk more clearly for patients diagnosed with epilepsy rather than with primary psychiatric disorders. However, the studies involved are limited by providing associational findings that may be confounded by several uncontrolled variables. Such limitations should be considered in future research on adverse effects of anticonvulsants and other centrally acting drugs. For now, however, clinical prudence calls for routine, ongoing assessment of mood and suicidal thoughts among neurological or psychiatric patients, whether or not treated with particular drugs. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Prevalence of risk factors for suicide in patients prescribed venlafaxine, fluoxetine, and citalopram,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2005
Daniel Mines MD
Abstract Purpose Three recent observational studies reported that the risk of fatal overdose is greater with venlafaxine than SSRI use. It is not clear whether patient factors could account for this finding. We evaluated whether risk factors for suicide are more prevalent among patients prescribed venlafaxine than patients prescribed fluoxetine or citalopram. Methods Using data from the UK General Practice Research Database (GPRD), we identified patients who were first prescribed any of the three drugs between January 1995 and April 2002. We ascertained risk factors for suicide documented in the 1 year before that first prescription. Separate analyses compared venlafaxine (N,=,27,096) and fluoxetine (N,=,134,996) cohorts, and venlafaxine and citalopram (N,=,52,035) cohorts. Results Previous suicidal behaviors were documented for 1.0% of the venlafaxine cohort compared to 0.4% of the fluoxetine cohort (OR 2.8, 95%CI: 2.4, 3.2) and 0.4% citalopram cohorts (OR 2.4, 95%CI: 2.0, 2.9). 72.5% of venlafaxine patients had been prescribed at least one other antidepressant compared to 27.6% of fluoxetine (OR 6.9, 95%CI: 6.7, 7.1) and 39.5% of citalopram (OR 4.0, 95%CI: 3.9, 4.2) patients. Venlafaxine patients were also four to six times as likely to have been previously hospitalized for depression. Conclusion In the UK, venlafaxine has been selectively prescribed to a patient population with a higher burden of suicide risk factors than patients prescribed fluoxetine and citalopram. Unless baseline population differences are accounted for, observational studies that compare the risk of suicide in patients receiving these agents may produce biased results. Copyright © 2005 John Wiley & Sons, Ltd. [source]