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Suicidal Behaviour (suicidal + behaviour)

Distribution by Scientific Domains

Medical Sciences	73%
Psychology	23%

Selected Abstracts

Suicide, suicidality and suicide prevention in affective disorders

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2003
H. J. Möller
Objective:, It is well known that functional psychiatric disorders are one of the main causes of suicidal behaviour. This paper discusses the epidemiology and risk factors of suicidal behaviour in affective disorders and goes on to describe the treatment and prevention of such suicidal behaviour. Method:, A narrative overview of relevant epidemiological and drug studies. Results:, About 60,70% of patients with acute depression experience suicidal ideas. There is a high incidence of suicide (10,15%) in depressive patients. Psychopharmacological treatment with antidepressants and/or mood stabilizers is the most successful approach to avoid the risk of suicidal behaviour. In addition, psychotherapeutic and psychosocial interventions are of importance. Conclusion:, Suicidal behaviour and suicide must be considered when treating patients with affective disorders. The complex causation of suicidality has to be borne in mind when considering methods of suicide prevention. In order to obtain the best results, psychosocial, psychotherapeutic and psychopharmacological approaches should be combined, depending on the risk factors of each individual patient. [source]

The Self-Injury Questionnaire: evaluation of the psychometric properties in a clinical population

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2006
E. E. SANTA MINA rn ba baan msc phd
This paper presents the findings, from a clinical study, on the reliability and validity of a new measure for intentions in self-harm behaviour, the Self-Injury Questionnaire (SIQ). Eighty-three patients, who had presented to an emergency department with an episode of self-harm/suicidal behaviour, were given the SIQ as part of a battery of measures to evaluate differentiation in self-harm intentions based upon a history of childhood physical and/or sexual abuse. The internal consistency for the total scale was strong (, = 0.83). Construct validity demonstrated significant correlations with standardized measures. A principle component analysis of responses yielded a five-factor solution with ,affect regulation' items loading on the first factor. Cronbach's alphas were adequate for each subscale (, = 0.72,0.77). These preliminary findings indicate that the SIQ is a valid and reliable measure for research in an acute self-harming population. [source]

Depression, hopelessness and suicide ideation among vulnerable prisoners

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2005
Emma J. Palmer PhD
Background Self-harm among prisoners is high, and suicide rates increasing. Assessment of depressive characteristics is easy. To what extent are these linked with previous self-harm? Aims To compare depressive characteristics of prisoners who report previous self-harm with those who do not. Methods Twenty-four new arrivals at an adult male category B local prison who reported previous episodes of suicidal behaviour (including self-harm and/or explicit attempted suicide) were assessed using the Beck Hopelessness Scale, the Beck Depression Inventory-II, and the Beck Scale for Suicide Ideation. A further 24 new arrivals were matched as closely as possible with them on sociodemographic and offending characteristics. Results Mean scores on the Beck Hopelessness Scale, the Beck Depression Inventory-II, and the Beck Scale for Suicide Ideation were significantly higher among the prisoners with a history of self-harm. Discussion Prisoners with a previous history of self-harm are more likely than those without to show a range of depressive symptoms than their imprisoned peers without such a history, suggesting a continued vulnerability to self-harm and perhaps suicide. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Recent time trends in levels of self-reported anxiety, mental health service use and suicidal behaviour in Stockholm

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010
K. Kosidou
Kosidou K, Magnusson C, Mittendorfer-Rutz E, Hallqvist J, Gumpert CH, Idrizbegovic S, Dal H, Dalman C. Recent time trends in levels of self-reported anxiety, mental health service use and suicidal behaviour in Stockholm. Objective:, To investigate recent time trends in several indicators of mental ill-health and the patterning of these indicators between genders and younger vs. older individuals in Stockholm County. Method:, Several indicators were used; self-reported anxiety from the Swedish Survey of Living Conditions, information on psychiatric in-patient and out-patient care, attempted and completed suicides from national and regional registers. Gender- and age-specific trends were compared for the time period of 1997,2006. Results:, Self-reported anxiety and psychiatric service use increased among young individuals of both genders, while attempted suicides increased only among young women. By contrast, these indicators decreased or remained stable in the older age group from year 2001 and onwards. Conclusion:, Our data indicate a rising, and highly prevalent, mental ill-health among the young in Stockholm County, a region representative of urbanized, secular Western societies. [source]

Baseline profiles of adolescent vs. adult-onset first-episode psychosis in an early detection program

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009
I. Joa
Objective:, Psychotic disorders often start in adolescence. We aim to investigate premorbid and baseline differences characterizing patients with an onset of psychosis in adolescence versus adulthood. Method:, We compare first-episode, DSM-IV non-affective psychosis with onset before (n = 43) and after (n = 189) 18 years on duration of untreated psychosis (DUP), level of symptoms, suicidal behaviour, and other baseline clinical and demographic characteristics. Results:, Adolescent onset patients had poorer premorbid functioning, a longer DUP, higher suicidality, and more depressive symptoms. They also had better cognition, fewer psychotic symptoms, and were more likely to be treated on an out-patient basis. Conclusion:, Adolescents with first-episode psychosis may have a slower and more silent, i.e. insidious onset, and are at risk of experiencing longer treatment delays than adults. They fit the description of what used to be labeled process (versus reactive) schizophrenia. [source]

Suicides and suicide ideation in the Bible: an empirical survey

ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2005
H. J. Koch
Objective:, The aim of this review is to summarize all data on suicidal behaviour reported in the Bible and to discuss basic implications for medical ethical positions. Method:, All books of the Jerusalem Bible, including the apocrypha accepted in the Catholic canon, were searched for all cases of suicide, attempted suicide and suicidal ideation clearly identifiable as such. Results:, The Bible including the apocrypha reports about 10 completed suicides and 11 cases of suicide attempt or ideation. The Bible considers human life as a divine gift but suicide per se is neither condemned nor approved. Those suffering from suicidal thoughts are treated with respect and support is offered. Conclusion:, Theological teaching on suicide was influenced for centuries by the biased negative opinion of the early fathers of the church and scholastic savants, but these opinions are not substantiated by a thorough reading of the Bible. [source]

Suicide, suicidality and suicide prevention in affective disorders

Family history of suicidal behaviour: prevalence and significance in deliberate self-harm patients

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2002
Keith Hawton
Objective:, To investigate whether there are differences between the characteristics of deliberate self-harm (DSH) patients with and without a family history of suicidal behaviour. Method:, In 146 DSH patients, those with and without a positive family history were compared with regard to the nature and repetition of their DSH episodes, and psychological and psychiatric characteristics. Results:, Fifty-two (35.6%) patients had a family history of suicidal behaviour. DSH was more frequent in patients' mothers (17.1%) than fathers (2.7%). Patients with a family history of suicidal behaviour, especially females, had higher state anger scores. Conclusion:, Family history of suicidal behaviour appears to be associated with greater anger. Absence of other associations suggests that family history probably has less implication for individuals who have already engaged in DSH than in contributing to its initiation. Future studies should include patients with violent or life-threatening DSH acts. [source]

Olanzapine in adolescents with schizophrenia who manifest suicidal behaviour

EARLY INTERVENTION IN PSYCHIATRY, Issue 2 2008
Andrea De Giacomo
No abstract is available for this article. [source]

Pros and cons of using the mental health act for severe eating Disorders in Adolescents

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2009
Agnes Ayton
Abstract Background In England and Wales the compulsory treatment of young people with severe eating disorders is controversial. There is a concern that such treatment may impair patient autonomy and negatively influence the outcome. In this study, based in a specialist hospital, we compared patients treated under parental consent with those detained under the Mental Health Act: their characteristics and outcome up to 12 months after discharge. Results 34 patients were informal (treated under parental consent) (age: 16.2,±,1.3 years) and 16 were treated under Section 3 of the Mental Health Act (age: 16.2,±,1) in a 3-year period. Detained patients had an earlier age of onset (12.2,±,5 vs. 14.3,±,1.8) and more previous hospitalisation. On admission, their psychosocial functioning (Children's Global Assessment Scale (C-GAS): 13.6,±,2 vs. 26.9,±,9; Health of the Nation Outcome Scale for Children and Adolescents (HONOSCA): 41.7,±,5 vs. 31.9,±,5) were worse than voluntary patients', they had a higher level of co-morbid depression (BDI: 38.1,±,15.6 vs. 26.6,±,12.4) and a higher rate of suicidal behaviour. All physical and psychosocial measures improved substantially and clinically significantly by discharge and there was no statistically significant difference at this stage between the two patient groups. Two informal patients died within a year after discharge (6.3%), but there were no deaths amongst the detained patients. Comments In contrast with previous findings in adults, the outcome for detained patients was similar to that for informal patients, despite the former having more severe presentation on admission. There was no evidence of higher mortality in the detained group. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Personality traits and self-injurious behaviour in patients with eating disorders

EUROPEAN EATING DISORDERS REVIEW, Issue 4 2008
Jennie Ahrén-Moonga
Abstract The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self-injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N,=,38) and age-matched controls (N,=,67) were examined concerning self-reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety-related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self-injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Life-time history of suicide attempts and coronary artery disease in a community-dwelling elderly population

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2006
S. Artero
Abstract Background Numerous studies have observed a strong relationship between coronary artery disease (CAD) and psychiatric disorder; notably depression, anxiety and panic attacks. No study has, however, explored the question of whether persons suffering from CAD might also be at high risk of suicide attempts. Objective The aim of the present study is to examine the relationship between CAD within a general population cohort and life-time history of psychiatric disorder and suicidal behaviour. Method A representative sample of 1843 non-institutionalized persons over 65, drawn at random from the electoral roll, was given a standardized neurological and psychiatric examination based on DSM-IV criteria. The clinical examination also included an electrocardiogram (ECG) and a questionnaire relating to life-time medical history. Cardiac events were validated by the general practitioner. Results Within this general population sample the prevalence of suicide attempts was 3.9%. A significant positive association was observed between life-time prevalence of CAD and suicide attempts (p,<,0.04). Suicide attempts were associated with major depression (p,<,0.001) co-morbid anxiety and depression (p,<,0.001) but not anxiety alone (p,=,0.16). A logistic regression analysis showed that the relationship between suicide attempts and CAD persists after adjustment for depression and anxiety. Conclusion CAD is associated with suicidal behaviour independently of depression, however, longitudinal studies are required to clarify the direction of causality and to integrate genetic, biological, environmental and psychological factors into an aetiological model. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Stressful life events and suicidal behaviour in countries with different development levels: Nicaragua, El Salvador, Chile and Spain

JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2010
José Juan Vázquez
Abstract This paper presents a study conducted on 709 Latin American undergraduates from four countries with different development levels (Nicaragua, El Salvador, Chile and Spain). The intention of this paper is to value the differences in the number and characteristics of stressful life events (SLE) suffered by the participants. Another purpose is to confirm the relation between SLE and suicidal conduct in Spanish cultural contexts, through the study of a multicultural sample of Spanish-speaking university students, and finally, to isolate the SLE that allow predicting a later suicidal conduct to a greatest extent. The information was collected by means of a self-applied questionnaire. The results indicate a greater presence of SLE among those who live in countries with lower development levels and among those who have attempted committing suicide. It is observed that the fact of having suffered certain SLE,physical or sexual mistreatment, excessive alcohol or drug consumption and having left home during childhood or adolescence,aid in the prediction of later suicidal conducts in the studied samples. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Integrating family therapy in adolescent depression: an ethical stance

JOURNAL OF FAMILY THERAPY, Issue 3 2009
Glenn Larner
Adolescent depression, particularly where suicidal behaviour is involved, is a complex and pressing mental health problem and demanding for families, therapists and services alike. This article reviews the evidence-based literature for adolescent depression including family therapy approaches. It suggests an integrative treatment approach that includes individual psychological treatment like CBT, medication where required and a family therapy intervention is supported by the literature. The focus of the latter is psychoeducation, building resilience and hope, enhancing communication, reducing relational conflict between parents and adolescents and addressing attachment and relationship issues. A systemic framework for integrating family therapy in the evidence- based treatment of adolescent depression is described. This is based on an ethic of hospitality towards different languages of therapy, which is illustrated by a detailed example from family therapy practice. [source]

The development of nurse-led suicide prevention training for multidisciplinary staff in a North Wales NHS Trust

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2010
R. JONES rmn bsc msc
Accessible summary ,,Suicide and suicidal behaviour evoke strong feelings. That is so not only for those directly affected , the individual, family and friends, but for professional staff and the community at large. ,,Assessing the risk of suicide demands staff having the ability to connect and maintain rapport with people in varying degrees of distress. ,,Multidisciplinary training groups allow staff the opportunity to share their experiences and learn from one another. ,,Suicide awareness training for non mental health staff in the UK is variable and should be more of a priority. Abstract There are 300 deaths in Wales each year as a result of suicide. Though the rate in England and Wales has fallen in recent years, it is still the second most common cause of death in men aged 15,44 behind accidental death. The majority of those who die by suicide make contact with health professionals within a relatively short time before their death. For those with mental ill health, relationships with professionals appear particularly important; indeed negative relationships have been cited as a key factor precipitating death by suicide. This paper outlines a suicide awareness programme which aims to restate the values of empathy and relationship building in everyday interaction. It acknowledges risk factors and risk assessment tools, but more than anything strives to demonstrate the value of encouraging personal expression in patients. [source]

The associations among personality disorder symptoms, suicide proneness and current distress in adult male prisoners,

PERSONALITY AND MENTAL HEALTH, Issue 4 2008
Dorian A. Lamis
Suicide is the 11th leading cause of death in the United States, and the third leading cause of death in US jails and penitentiaries. Research has shown that the presence of an Axis II personality disorder (PD) increases the risk for suicidal behaviour. While many correctional institutions screen inmates for suicidal ideation upon intake, they can neglect to assess for the presence of PD symptoms other than those associated with criminality such as Antisocial PD. The current study examined whether symptoms of various PDs were associated with self-reports of current suicide proneness and distress in a small sample of adult male inmates residing in a medium or a maximum security facility. As hypothesized, elevated scores on numerous PD Millon Clinical Multiaxial Inventory-III scales (e.g. Schizoid, Depressive, Sadistic, Schizotypal, Borderline) were significantly associated with both self-reports of current suicide proneness and psychological distress. Once the nature of these associations in inmates is better understood, more effective suicide prevention programs can be designed and implemented in correctional facilities. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Antiepileptic drugs and risk of suicide: a nationwide study

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2010
Jonas Bjerring Olesen MB
Abstract Purpose Patients with epilepsy or psychiatric diseases have increased risk of suicide, but whether the risk is influenced by antiepileptic drug (AED) treatment is unclear. Studies have suggested that AEDs in general increase the risk of suicidal behaviour shortly after initiation. This study investigated possible differences in suicide risk associated with different AEDs. Methods The use of AEDs in the Danish population from 1997 to 2006 was determined by prescription claims. The risk of suicide associated with use of AEDs was estimated by case-crossover analyses, where each case serves at its own control during different periods. For sensitivity, the risk of suicide was estimated by a time-dependent Cox proportional-hazard analysis in AED treatment-naïve patients. Results There were 6780 cases committing suicide in the 10-year study period, of which 422 received AED treatment at the time of suicide. The case-crossover analysis estimated AED treatment initiation to increase the risk of suicide (odds ratio (OR): 1.84, 95% confidence interval (CI): 1.36,2.49). Clonazepam (OR: 2.01, CI: 1.25,3.25), valproate (OR: 2.08, CI: 1.04,4.16), lamotrigine (OR: 3.15, CI: 1.35,7.34) and phenobarbital (OR: 1.96, CI: 1.02,3.75) were associated with a significant increased risk, while the remaining examined AEDs did not significantly influence the risk. In the cohort comprising of 169,725 AED treatment-naïve patients, the Cox proportional-hazard analysis yielded similar results. Conclusions This study suggests that clonazepam, valproate, lamotrigine and phenobarbital relatively shortly after treatment initiation may increase the risk of suicide. The increased risk of suicide associated with these AEDs appears to be a consistent finding. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Bipolar depression: phenomenological overview and clinical characteristics

BIPOLAR DISORDERS, Issue 6 2004
Philip B Mitchell
Objectives:, There has been increasing interest in the depressed phase of bipolar disorder (bipolar depression). This paper aims to review the clinical characteristics of bipolar depression, focusing upon its prevalence and phenomenology, related neuropsychological dysfunction, suicidal behaviour, disability and treatment responsiveness. Methods:, Studies on the prevalence of depression in bipolar disorder, the comparative phenomenology of bipolar and unipolar depression, as well as neuropsychology and brain imaging studies, are reviewed. To identify relevant papers, a literature search using MEDLINE and PubMed was undertaken. Results:, Depression is the predominant mood disturbance in bipolar disorder, and most frequently presents as subsyndromal, minor or dysthymic depression. Compared with major depressive disorder (unipolar depression), bipolar depression is more likely to manifest with psychosis, melancholic symptoms, psychomotor retardation (in bipolar I disorder) and ,atypical' symptoms. The few neuropsychological studies undertaken indicate greater impairment in bipolar depression. Suicide rates are high in bipolar disorder, with suicidal ideation, suicide attempts and completed suicides all occurring predominantly in the depressed phase of this condition. Furthermore, the depressed phase (even subsyndromal) appears to be the major contributant to the disability related to this condition. Conclusions:, The significance of the depressed phase of bipolar disorder has been markedly underestimated. Bipolar depression accounts for most of the morbidity and mortality due to this illness. Current treatments have significant limitations. [source]

Serotonergic dysregulation in bipolar disorders: a literature review of serotonergic challenge studies

BIPOLAR DISORDERS, Issue 6 2002
S Sobczak
Objectives:, Serotonin (5-hydroxytryptamine; 5-HT) and endocrine abnormalities have been repeatedly reported in bipolar disorders (BD). Useful methods to investigate 5-HT responsivity, and the interaction with neuroendocrine functioning, are provided by acute 5-HT challenge and depletion paradigms. In this review 5-HT challenges are limited to paradigms that stimulate 5-HT activity in BD. Methods:, Literature was searched for in electronic libraries: MEDLINE and PSYCHLIT, period 1966,2001. Papers describing effects of an acute 5-HT challenge on neuroendocrine functioning in BD patients were selected. Results:, Review of the literature revealed 15 studies: five papers described the effects of 5-HT challenges in manic BD patients, four papers in euthymic BD and seven in depressed BD patients. The reviewed 5-HT challenge paradigms are acute administration of oral and intravenous (i.v.) dosage of d,l-fenfluramine, tryptophan, 5-hydroxytryptophan, ipsapirone and buspirone. There were no papers which investigated neuroendocrine effects of m-chlorophenylpiperazine, clomipramine and citalopram in BD patients and were therefore not reviewed. Conclusions:, The literature on 5-HT challenge procedures in BD shows evidence for a blunted prolactin (PRL) in mania and depression as well as a blunted cortisol in euthymic BD patients. This suggests that in both mania and depression similar changes in the 5-HT system are involved. It is speculated that blunting of cortisol responses in euthymic BD patients may be a result of chronically altered 5-HT functioning, whereas changes in PRL release following 5-HT challenges reflect more state-dependent changes in 5-HT activity. The 5-HT responsivity in BD patients has also been associated with pharmacological treatment, suicidal behaviour, weight loss and age. Recommendations for future research are given. [source]

Alcohol-dependent patients attempting and not attempting suicide: a comparison

ACTA NEUROPSYCHIATRICA, Issue 4 2004
Özkan Pekta
Background:, Alcohol dependence is a psychiatric disorder associated with an increased risk of suicidal behaviour. This is also associated with an increased number of suicide risk factors. Objective:, The current study examined the sociodemographic and clinical characteristics of a number of alcohol-dependent patients who attempted suicide. Methods:, We studied a consecutive series of 377 alcohol-dependent patients in our in-patient clinics. Their alcohol-use histories were assessed through semistructured interviews. The Suicidal Behaviors Questionnaire, the Childhood Trauma Questionnaire, the Michigan Alcoholism Screening Test and the Hamilton Depression Rating Scale were administered to all patients. Serum total cholesterol levels, mean corpuscular volume, the liver enzymes gamma glutamyl transferase, aspartate aminotransferase and alanine aminotransferase were routinely measured. In the statistical analyses, Student's t -test and chi-squared tests were applied. Results:, Of the 377 alcohol-dependent patients, 89 (23.6%) had histories of attempted suicide. Thirty-four (42.5%) of the 80 female alcohol-dependent patients and 55 (18.5%) of the 297 male alcohol-dependent patients had attempted suicide; this gender difference was statistically significant (,2 = 27.7, P < 0.001). A greater proportion of the suicide attempters than of the non-attempters met the Diagnostic Statistical Manual IV criteria for another psychiatric disorder (60.6%, n = 54, vs. 40.6%, n = 117; ,2 = 14.8; df = 6; P < 0.05). The difference of total cholesterol levels between female (mean = 144.0, SD = 58.3; mean = 158.0, SD = 83.9; t = 4.5; P < 0.05) and male (mean = 133.7, SD = 50.5; mean = 163.6, SD = 69.7; t = 11.7; P < 0.01) attempters and non-attempters was statistically significant. Conclusion:, These results suggest that suicide attempts in alcohol-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels. [source]

Seasonal variation and meteotropism in suicide: clinical relevance of findings and implications for research

ACTA NEUROPSYCHIATRICA, Issue 1 2002
A. Preti
Seasonal asymmetry in yearly suicide occurrence is a long-observed phenomenon in psychiatric, suicidological and sociological research, and the effects of seasonal factors on suicidal behaviour have been the focus of a number of earlier studies. Taking into account limitations of data and methods, these studies have in general favoured interpretations based on psychosocial factors. Recent studies have challenged the widely held notion that seasonal effects on suicide are not influenced by age, gender or the circumstances of the act. The suicides committed with violent methods have been shown to follow clearer seasonal patterns than suicides by less violent methods, and differences have been found between male and female cycles of occurrence. The seasonal occurrence of suicides has also been found to differ significantly between the young and the elderly. The use of inappropriate statistics or age- and gender-biased samples may have hidden a seasonal component in some previous studies on attempted suicide. The absence of seasonality in earlier studies on attempted suicide was interpreted as depending upon the minor relevance of psychiatric and biological factors in non-fatal self-harm. However, recent studies have reported clear seasonality in attempted suicide samples, with older people showing greater seasonal effect. Recent literature after 1985 on seasonal variation and weather or climate influence in attempted and completed suicide is reviewed. Suggestions for research and the development of more effective preventative strategies are offered. [source]

Patterns and correlates of substance use amongst juvenile detainees in New South Wales 1989,99

DRUG AND ALCOHOL REVIEW, Issue 1 2003
JAN COPELAND
Abstract In the decade 1989,99 there have been significant changes in the patterns of substance use in the Australian community. Juvenile offenders have been a sentinel population of these emerging trends. The social and personal costs associated with adolescent substance use, especially where it leads to increased criminal offending requires urgent attention. This study was a replication of the 1989 and 1994 surveys of young people in detention in New South Wales, Australia. The 300 voluntary participants from nine detention centres had a similar demographic profile to participants of the previous surveys. They were predominantly male (90%) with a mean age of 16.5 years and an over-representation of Aboriginal and Torres Straits Islander peoples. The patterns of lifetime alcohol and tobacco use were stable over the decade, with particular increases in amphetamine, opioid and cocaine use since 1994. The more concerning pattern of at least weekly substance use revealed significant increases in cannabis, opioid and cocaine use since 1994, but a significant decrease in the frequent use of alcohol. This study also reports on high levels of negative health and psychosocial consequences of substance use, including overdose, among this group. High levels of self-reported depression and suicidal behaviours, family and gender issues are also discussed. Encouragingly, there was a relatively high level of self-recognized treatment need for substance use and mental health problems among the sample. This highlights further the growing need for the development and dissemination of novel interventions that harness this willingness and actively engage, motivate and maintain these young people in accessible, appropriate and effective interventions. [source]

Serotonin, personality and borderline personality disorder

ACTA NEUROPSYCHIATRICA, Issue 2 2002
M. Hansenne
Serotonin is one of the neurotransmitters implicated in normal personality. Many psychobiological models of personality include some dimensions related to serotonin. For instance, the harm avoidance dimension of the biosocial model developed by Cloninger is related to serotonergic activity. Higher scores on the harm avoidance dimension should theoretically reflect increased serotonergic activity. However, correlation studies related serotonin activity to harm avoidance dimension have not yielded consistent findings. These controversial results are probably related to the complexity of the neurotransmitter systems, and the different assessment techniques used in these studies. Finally, recent genetic studies have examined the association between personality dimensions and serotonergic receptor polymorphisms with mixed results. Serotonin is not only related to some dimensions of normal personality. Several psychopathological disorders are associated with serotonergic dysfunction. More particularly, borderline personality disorder (BPD) can be defined by many of the symptoms associated with serotonergic dysregulation, including affective lability, suicidal behaviours, impulsivity and loss of impulse control. Indeed, several reports have demonstrated the efficacy of selective serotonin re-uptake drugs in treating the depressive and impulsive symptoms of patients with BPD. Moreover, some challenge studies have reported a lower serotonergic activity in BPD. Because these challenges are not specific, we have assessed the serotonergic activity in BPD with the flesinoxan challenge. Preliminary results showed that the prolactine responses to flesinoxan were significantly lower in BPD patients compared to those observed in controls. [source]

The psychological and neurophysiological concomitants of mindfulness forms of meditation

ACTA NEUROPSYCHIATRICA, Issue 2 2007
Belinda Ivanovski
Objective:, To provide a comprehensive review and evaluation of the psychological and neurophysiological literature pertaining to mindfulness meditation. Methods:, A search for papers in English was undertaken using PsycINFO (from 1804 onward), MedLine (from 1966 onward) and the Cochrane Library with the following search terms: Vipassana, Mindfulness, Meditation, Zen, Insight, EEG, ERP, fMRI, neuroimaging and intervention. In addition, retrieved papers and reports known to the authors were also reviewed for additional relevant literature. Results:, Mindfulness-based therapeutic interventions appear to be effective in the treatment of depression, anxiety, psychosis, borderline personality disorder and suicidal/self-harm behaviour. Mindfulness meditation per se is effective in reducing substance use and recidivism rates in incarcerated populations but has not been specifically investigated in populations with psychiatric disorders. Electroencephalography research suggests increased alpha, theta and beta activity in frontal and posterior regions, some gamma band effects, with theta activity strongly related to level of experience of meditation; however, these findings have not been consistent. The few neuroimaging studies that have been conducted suggest volumetric and functional change in key brain regions. Conclusions:, Preliminary findings from treatment outcome studies provide support for the application of mindfulness-based interventions in the treatment of affective, anxiety and personality disorders. However, direct evidence for the effectiveness of mindfulness meditation per se in the treatment of psychiatric disorders is needed. Current neurophysiological and imaging research findings have identified neural changes in association with meditation and provide a potentially promising avenue for future research. [source]