Home About us Contact
|
Home About us Contact | ||
|
|
||
Suicidal Thoughts (suicidal + thought)
Selected AbstractsChildren at Risk: The Association Between Perceived Weight Status and Suicidal Thoughts and Attempts in Middle School Youth,JOURNAL OF SCHOOL HEALTH, Issue 2 2007Lauren M. Whetstone PhD ABSTRACT Background:, Suicide is one of the most common causes of death among young people. A report from the US Surgeon General called for strategies to prevent suicide, including increasing public awareness of suicide and risks factors, and enhancing research to understand risk and protective factors. Weight perception has been linked to depression and poor self-esteem in adolescents. The purpose of this study was to examine the relationship between perceived weight status and suicidal thoughts and actions by gender in middle school youth. Methods:, All public middle school students in 4 eastern North Carolina counties presented, and with parental permission (n = 5174), completed the Youth Risk Behavior Survey: Middle School Questionnaire. The 3 dependent variables were self-reported thinking, planning, and attempting suicide. Bivariate analyses describe suicidal thoughts and actions; multiple logistic regression models examined the relationship between weight description and suicidal thoughts and actions controlling for age, race, household composition, grades on report cards, and parents' education. Results:, Significantly more females than males reported thinking (26% vs 19%), planning (12% vs 9%), and attempting (11% vs 8%) suicide. For females, those who perceived themselves as overweight were significantly more likely to report suicidal thoughts and actions; while for males, perceptions of overweight and underweight were significantly associated with suicidal thoughts and actions. Conclusions:, Controlling for personal and family characteristics, perceived weight status was significantly associated with suicidal thoughts and actions in middle school boys and girls. [source] Suicidal thoughts among elderly Taiwanese aboriginal womenINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2008Cheng-Sheng Chen Abstract Objectives The aims of this study were to investigate prevalence of suicidal thoughts among a population of elderly aboriginal women in Taiwan over a 1-month period and to examine the risk factors for suicidal thinking in terms of individual (self-perceived health, disability and financial difficulty), family (marital discord) and social (medical accessibility) aspects. The mediating effects of depression on the above risk factors were also investigated. Furthermore, we examined the buffer effect on suicidal ideation of emotional social support for dealing with marital discord. Methods One thousand three hundred and forty-seven elderly Taiwanese aboriginal women were enrolled. Suicide thoughts within the past month, demographic data, adverse life events, emotional social support and depressive state were assessed. The 1-month prevalence of suicide thoughts was calculated. The risks of suicide thought based on individual, family and community aspects were estimated. Results The 1-month prevalence of suicidal thoughts among the community-dwelling aboriginal elderly women was 17.8%. Those subjects with poorer self-perceived health, difficulty in accessing medical resources, or experiencing marital discord were at higher risk of having suicidal thoughts. After controlling for depression, the odds ratio of self-perceived health and marital discord remained statistically significant. The odds ratio of interaction of marital discord and emotional social support was 0.41. Conclusion Suicidal thoughts are common among the community-dwelling aboriginal elderly women in Taiwan. Risk factors for suicidal thoughts comprise individual (depression and physical condition), family (marital discord) and community (medical resources) aspects. Better emotional social support can effectively buffer the effect of marital discord. Copyright © 2008 John Wiley & Sons, Ltd. [source] The subjective experience of taking antipsychotic medication: a content analysis of Internet dataACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009J. Moncrieff Objective:, We explored the subjective effects associated with olanzapine, risperidone and older antipsychotics. Method:, We conducted a content analysis of an Internet database of comments about prescribed medications. Results:, We analysed 223 comments on risperidone, 170 on olanzapine and 46 relating to three older antipsychotics. The predominant subjective effects produced by all drugs consisted of sedation, cognitive impairment and emotional flattening or indifference. Connections appeared between these effects and Parkinsonian-like symptoms with the older drugs, sexual impairment with risperidone and metabolic effects with olanzapine. The experience of akathisia was frequently linked to suicidal thoughts. Some respondents described how the drugs' subjective effects helped to reduce symptoms of mania, psychosis and anxiety. Conclusion:, The generalisability of Internet data is uncertain. However, the data suggest that adverse subjective effects play a central role in the experience of taking antipsychotic drugs and may be related to the drugs' desired benefits. [source] Suicides and suicide ideation in the Bible: an empirical surveyACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2005H. 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] Suicidal feelings run high among mothers in refugee camps: a cross-sectional surveyACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2003A. Rahman Objective: To study levels of mental distress in a sample of Afghan mothers caring for children in two refugee camps in North West Frontier Province (NWFP) of Pakistan. Method: Cross-sectional survey of 297 consecutive mothers with young children, attending primary care centres, using a psychiatric screening instrument, the Self-Reporting Questionnaire (SRQ-20). Results: One hundred and six (36%) of women in the sample screened positive for a common mental disorder. Ninety-six (91%) of those screening positive had had suicidal thoughts in the previous month, and nine (8%) rated suicidal feeling as their topmost concern. Conclusion: There is a high prevalence and severity of mental distress in Afghan mothers caring for young children in refugee camps. This may have serious long-term effects on the psychological and physical development of their children. [source] Psychiatric comorbidity and suicidal behavior in epilepsy: A community-based case,control studyEPILEPSIA, Issue 7 2010Sabrina 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] Psychiatric Comorbidity in Epilepsy: A Population-Based AnalysisEPILEPSIA, Issue 12 2007Jose F. Tellez-Zenteno Summary Purpose: The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey. Methods: The Canadian Community Health Survey (CCHS 1.2) was used to explore numerous aspects of mental health in persons with epilepsy in the community compared with those without epilepsy. The CCHS includes administration of the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects. Age-specific prevalence of mental health conditions in epilepsy was assessed using logistic regression. Results: The prevalence of epilepsy was 0.6%. Individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts with odds ratio of 2.4 (95% CI = 1.5,3.8) and 2.2 (1.4,3.3), respectively. In the crude analysis, the odds of lifetime major depression or panic disorder/agoraphobia were not greater in those with epilepsy than those without epilepsy, but the association with lifetime major depression became significant after adjustment for covariates. Conclusions: In the community, epilepsy is associated with an increased prevalence of mental health disorders compared with the general population. Epilepsy is also associated with a higher prevalence of suicidal ideation. Understanding the psychiatric correlates of epilepsy is important to adequately manage this patient population. [source] Lesbian, gay, bisexual and transgender young people's experiences of distress: resilience, ambivalence and self-destructive behaviourHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2008Jonathan Scourfield BA MA DipSW PhD Abstract The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. [source] Depressive symptoms and suicidal ideation among older adults receiving home delivered mealsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2008Jo Anne Sirey Abstract Objective Homebound older adults may be vulnerable to the deleterious impact of untreated depression. Yet because these elders are difficult to reach, there is little data on the rates of depressive symptoms and suicidal ideation among this group. The objective of this study is to document the rates of depression and correlates among a population of homebound elders. Methods Using a community based participatory research partnership, we implemented a routine screening for depressive symptoms and suicidal ideation among older recipients of Westchester County's home meal program. Older adults enrolled in the home delivered meal program were administered the Physician Health Questionnaire,9 (PHQ-9), and questions to assess pain, falls, alcohol abuse and perceived emotional distress. Results In our sample of 403 meal recipients, 12.2% of older adults reported clinically significant depression (PHQ-9,>,9) and 13.4% reported suicidal thoughts. One-third of recipients with significant depressive symptoms were currently taking an antidepressant. Almost one-third of older adults who endorsed suicide ideation did not report clinically significant depressive symptoms. Among men, suicidal thoughts were associated with chronic pain and greater depression severity, whereas pain was not a predictor of suicidal thoughts among women. Conclusion More than one in nine elders suffer from depression; most are untreated with one-third undertreated. Through partnerships between public agencies that provide age related services and academic investigators there is an opportunity for improved detection of unmet mental health needs. Future research should explore innovative models to improve access to mental health services once unmet need is detected. Copyright © 2008 John Wiley & Sons, Ltd. [source] Suicidal thoughts among elderly Taiwanese aboriginal womenINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 10 2008Cheng-Sheng Chen Abstract Objectives The aims of this study were to investigate prevalence of suicidal thoughts among a population of elderly aboriginal women in Taiwan over a 1-month period and to examine the risk factors for suicidal thinking in terms of individual (self-perceived health, disability and financial difficulty), family (marital discord) and social (medical accessibility) aspects. The mediating effects of depression on the above risk factors were also investigated. Furthermore, we examined the buffer effect on suicidal ideation of emotional social support for dealing with marital discord. Methods One thousand three hundred and forty-seven elderly Taiwanese aboriginal women were enrolled. Suicide thoughts within the past month, demographic data, adverse life events, emotional social support and depressive state were assessed. The 1-month prevalence of suicide thoughts was calculated. The risks of suicide thought based on individual, family and community aspects were estimated. Results The 1-month prevalence of suicidal thoughts among the community-dwelling aboriginal elderly women was 17.8%. Those subjects with poorer self-perceived health, difficulty in accessing medical resources, or experiencing marital discord were at higher risk of having suicidal thoughts. After controlling for depression, the odds ratio of self-perceived health and marital discord remained statistically significant. The odds ratio of interaction of marital discord and emotional social support was 0.41. Conclusion Suicidal thoughts are common among the community-dwelling aboriginal elderly women in Taiwan. Risk factors for suicidal thoughts comprise individual (depression and physical condition), family (marital discord) and community (medical resources) aspects. Better emotional social support can effectively buffer the effect of marital discord. Copyright © 2008 John Wiley & Sons, Ltd. [source] Completed suicide among psychiatric in-patients with depression in an Australian mental hospitalINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000Ajit Shah Abstract Up to 45% of completed psychiatric in-patient suicides have a diagnosis of depression. Twenty-two completed psychiatric in-patient suicides with depression, over a 21-year period, in a large psychiatric hospital in Melbourne, Australia, were examined. The characteristics, including demographic and clinical data, for the completed suicides with depression were compared with a comparison group of ,alive' in-patients with depression. Completed suicide among psychiatric in-patients with depression was associated with male sex, suicidal thoughts during admission, and fluctuating suicidal ideation or continuous absence of suicidal ideation. Over 40% of completed suicides occurred whilst on approved leave and over 20% after absconding from the hospital. Violent methods (including jumping in front of trains, trams and road traffic, jumping of buildings, hanging and drowning) were used in over 65% of completed suicides. Psychiatric units should be developed away from readily available methods of suicide. In-patients with suicidal thoughts during the admission and unstable suicidal ideation should be carefully observed to avoid absconding and suicide, and should be carefully assessed prior to granting of leave. Copyright © 2000 Whurr Publishers Ltd. [source] Self-injury: A research review for the practitionerJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2007E. David Klonsky Non-suicidal self-injury is the intentional destruction of body tissue without suicidal intent and for purposes not socially sanctioned. In this practice-friendly review, the authors summarize the empirical research on who self-injures, why people self-injure, and what treatments have demonstrated effectiveness. Self-injury is more common in adolescents and young adults as compared to adults. Common forms include cutting, severe scratching, burning, and banging or hitting; most individuals who self-injure have used more than one method. Although diagnostically heterogeneous, self-injurers typically exhibit two prominent characteristics: negative emotionality and self-derogation. Self-injury is most often performed to temporarily alleviate intense negative emotions, but may also serve to express self-directed anger or disgust, influence or seek help from others, end periods of dissociation or depersonalization, and help resist suicidal thoughts. Psychotherapies that emphasize emotion regulation, functional assessment, and problem solving appear to be most effective in treating self-injury. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 1045,1056, 2007. [source] The pharmacology and epidemiology of post-market surveillance for suicide: the case of gabapentinJOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH, Issue 2 2010Jill E. Lavigne Abstract Objectives, To describe the challenges in measurement of suicidal thoughts and behaviours and any causal relationship to prescription drug exposures. Recent US Food and Drug Administration (FDA) investigations of potential provocation of suicidal ideation and behaviour have led to black-box warnings of suicidal thoughts and behaviour on drugs ranging from smoking cessation to urinary incontinence agents. We describe the challenges faced in studying the effects of specific drug exposures on suicidal thoughts and behaviours using gabapentin (Neurontin) as an example because it has been implicated by the FDA as a drug that may induce suicidal thoughts or behaviours, offers more than 20 diverse indications including several known to be associated with an increase in suicide risk, and derives its clinical effect from 2 divergent mechanisms. Key findings, Gabapentin has two primary mechanisms: GABAergic neurotransmission and interruption of sodium and calcium channels. An increase in GABAergic neurotransmission is expected to improve anxiety and essential tremor, but to have no effect on pain, specifically migraine and neuropathic pain. Improvements in pain after gabapentin exposure are likely the result of the interruption of calcium and sodium channels. Neither mechanism is expected to affect bipolar disorder or schizophrenia, serious mental illnesses associated with a risk of suicide. Conclusions, These two independent mechanisms are expected to have mutually exclusive effects on a wide range of indications, only some of which are associated with increased risk of suicide. This very complexity and heterogeneity may present fertile ground for research aimed at not only improving our understanding of drug action, but also at expanding our knowledge of suicidal thoughts and behaviours. [source] Body Weight Perception, Unhealthy Weight Control Behaviors, and Suicidal Ideation Among Korean AdolescentsJOURNAL OF SCHOOL HEALTH, Issue 12 2009Dong-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] Children at Risk: The Association Between Perceived Weight Status and Suicidal Thoughts and Attempts in Middle School Youth,JOURNAL OF SCHOOL HEALTH, Issue 2 2007Lauren M. Whetstone PhD ABSTRACT Background:, Suicide is one of the most common causes of death among young people. A report from the US Surgeon General called for strategies to prevent suicide, including increasing public awareness of suicide and risks factors, and enhancing research to understand risk and protective factors. Weight perception has been linked to depression and poor self-esteem in adolescents. The purpose of this study was to examine the relationship between perceived weight status and suicidal thoughts and actions by gender in middle school youth. Methods:, All public middle school students in 4 eastern North Carolina counties presented, and with parental permission (n = 5174), completed the Youth Risk Behavior Survey: Middle School Questionnaire. The 3 dependent variables were self-reported thinking, planning, and attempting suicide. Bivariate analyses describe suicidal thoughts and actions; multiple logistic regression models examined the relationship between weight description and suicidal thoughts and actions controlling for age, race, household composition, grades on report cards, and parents' education. Results:, Significantly more females than males reported thinking (26% vs 19%), planning (12% vs 9%), and attempting (11% vs 8%) suicide. For females, those who perceived themselves as overweight were significantly more likely to report suicidal thoughts and actions; while for males, perceptions of overweight and underweight were significantly associated with suicidal thoughts and actions. Conclusions:, Controlling for personal and family characteristics, perceived weight status was significantly associated with suicidal thoughts and actions in middle school boys and girls. [source] Mobile Crisis Team Intervention to Enhance Linkage of Discharged Suicidal Emergency Department Patients to Outpatient Psychiatric Services: A Randomized Controlled TrialACADEMIC EMERGENCY MEDICINE, Issue 1 2010Glenn W. Currier MD Abstract Objectives:, Many suicidal patients treated and released from emergency departments (ED) fail to follow through with subsequent outpatient psychiatric appointments, often presenting back for repeat ED services. Thus, the authors sought to determine whether a mobile crisis team (MCT) intervention would be more effective than standard referral to a hospital-based clinic as a means of establishing near-term clinical contact after ED discharge. This objective was based on the premise that increased attendance at the first outpatient mental health appointment would initiate an ongoing treatment course, with subsequent differential improvements in psychiatric symptoms and functioning for patients successfully linked to care. Methods:, In a rater-blinded, randomized controlled trial, 120 participants who were evaluated for suicidal thoughts, plans, or behaviors, and who were subsequently discharged from an urban ED, were randomized to follow-up either in the community via a MCT or at an outpatient mental health clinic (OPC). Both MCTs and OPCs offered the same structured array of clinical services and referral options. Results:, Successful first clinical contact after ED discharge (here described as "linkage" to care) occurred in 39 of 56 (69.6%) participants randomized to the MCT versus 19 of 64 (29.6%) to the OPC (relative risk = 2.35, 95% CI = 1.55,3.56, p < 0.001). However, we detected no significant differences between groups using intention-to-treat analyses in symptom or functional outcome measures, at either 2 weeks or 3 months after enrollment. We also found no significant differences in outcomes between participants who did attend their first prescribed appointment via MCT or OPC versus those who did not. However divided (MCT vs. OPC, present at first appointment vs. no show), groups showed significant improvements but maintained clinically significant levels of dysfunction and continued to rely on ED services at a similar rate in the 6 months after study enrollment. Conclusions:, Community-based mobile outreach was a highly effective method of contacting suicidal patients who were discharged from the ED. However, establishing initial postdischarge contact in the community versus the clinic did not prove more effective at enhancing symptomatic or functional outcomes, nor did successful linkage with outpatient psychiatric care. Overall, participants showed some improvement shortly after ED discharge regardless of outpatient clinical contact, but nonetheless remained significantly symptomatic and at risk for repeated ED presentations. ACADEMIC EMERGENCY MEDICINE 2010; 17:36,43 © 2009 by the Society for Academic Emergency Medicine [source] Suicide risk during anticonvulsant treatment,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2010Maurizio 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] Latest news and product developmentsPRESCRIBER, Issue 17 2008Article first published online: 15 SEP 200 Small AED suicide risk Antiepileptic drugs (AEDs) are associated with a small increase in the risk of suicidal thoughts, the MHRA has warned. In the latest Drug Safety Update (2008;2:Issue 1) the MHRA says that, compared with placebo, AEDs are associated with an additional two cases of suicidal thoughts and behaviour per 1000 patients (0.43 vs 0.22 per cent). This may occur as early as one week after starting treatment. It is unclear whether the risk varies among AEDs. Also in this issue, the MHRA warns of an increased risk of tumour progression and reduced survival in patients with cancer treated with recombinant erythropoietin. Other topics include the use of lenalidomide (Revlimid) and thalidomide for multiple myeloma; new restrictions on the use of moxifloxacin (Avelox) due to adverse effects; and a reminder that metronidazole should be administered orally, not by intravenous injection, for the treatment of C. difficile -associated diarrhoea. Low-fat diet least effective option? A low-fat diet is associated with less weight loss and less favourable metabolic changes over two years than a low-carbohydrate (Watkins) diet or a Mediterranean diet in 322 moderately obese patients (mean BMI 30kg per m2; N Eng J Med 2008;359:229,41). Estimated energy intake was similar for all diets. Mean weight loss in all randomised patients was 2.9kg for the low fat diet, 4.4kg for the Mediterranean diet and 4.7kg for the low-carbohydrate diet. The low-carbohydrate diet was associated with greater increases in HDL-cholesterol and greater reductions in triglycerides and total cholesterol/HDL-C ratio compared with the low-fat diet. Among people with diabetes, fasting plasma glucose and insulin resistance were decreased only in those assigned to the Mediterranean diet, and only the low carbohydrate diet significantly decreased HbA1c. Stopping post-MI statins Patients who stop taking a statin first prescribed after an acute MI almost double their risk of death compared with nonusers, a new study shows (Eur Heart J; published online 29 July 2008; doi: 10.1093/eurheartj/ehn346). The analysis of 9939 MI survivors in the General Practice Research Database showed that, compared with patients who had never used a statin, the risk of death was unchanged for those previously taking a statin who continued treatment after MI. The risk was reduced by 28 per cent for those who started a statin post-MI and continued it but, in those who started a statin but then stopped it, the hazard ratio for death was 1.88 (CI 95% 1.13-3.07). Stopping control medication (aspirin, beta-blockers or proton pump inhibitors) did not alter the risk of death. Smoking quit rates with NRT and varenicline Differences in quit rates between nicotine replacement therapy (NRT) and varenicline (Champix) are small, according to a multinational study (Thorax 2008;63:717,24). The trial compared transdermal NRT (21mg to 7mg per day over 10 weeks) with varenicline (1mg twice daily for 12 weeks). Over the final four weeks of treatment, the abstinence rate was significantly higher with varenicline (56 vs 43 per cent). After one year, the four-week abstinence rates were 26 and 20 per cent respectively (p = 0.056) and seven-day point prevalence abstinence rates at 6 or 12 months were not significantly different. Varenicline reduced craving, withdrawal symptoms and smoking satisfaction compared with NRT but at the cost of a higher incidence of nausea (37 vs 10 per cent). Azithromycin goes OTC The MHRA has announced that azithromycin will be available without prescription for the treatment of Chlamydia infection. Under the brand Clamelle, azithromycin will be supplied from pharmacies to over-16s who have tested positive for infection but have no symptoms; their partners may also be treated. A urine testing kit will be marketed to pharmacists. Product news Sodium valproate (Epilim Chronosphere) is now available as modified-release granules to be taken with food or a drink; 30 sachets, in five strengths from 50750mg, cost £30. Boehringer Ingelheim has introduced a higher strength of its telmisartan/hydrochlorothiazide combination (Micardis Plus) for hypertension; 80mg/25mg costs £14.18 for a month's supply. Copyright © 2008 Wiley Interface Ltd [source] Suicidal ideation and associated factors among community-dwelling elders in TaiwanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2005YUNG-CHIEH YEN md Abstract, The purpose of the present study was to explore the suicidal ideation of community-dwelling elderly and the factors associated with their intention to commit suicide. Using a multilevel stratified sampling strategy, 1000 elderly subjects were recruited (aged 65,74 years old) in Taiwan during the year 2001. The degree of depression and its correlates were assessed. Suicidal ideation was measured by asking respondents if they had had any suicidal thoughts in the previous week. In all, 16.7% of respondents reported suicidal ideation within the past week; its occurrence was related to sex, religious belief, employment status, marital status, average family monthly income, physical health status, depressive symptoms, and community activity participation. Further multivariate logistic regression revealed that, aside from depressive symptoms and a lower level of education, no community participation in the past 6 months was significantly associated with the appearance of suicidal ideation. The prevalence of suicidal ideation among the elderly in Taiwan is higher than in Western countries. Participation in social activities is negatively associated with elderly suicidal ideation. The dimension of social participation deserves further exploration and should be considered in community mental health promotion interventions for elderly people. [source] Mental Health and Wellbeing and UnemploymentTHE AUSTRALIAN ECONOMIC REVIEW, Issue 2 2000Paul Flatau This article examines the relationship between mental health and wellbeing and unemployment utilising the 1995 National Health Survey (1995 NHS) and the 1997 National Survey of Mental Health and Wellbeing of Adults (1997 SMHWB) data sets. Three indicators of mental health and wellbeing are adopted. The first is a psychological wellbeing measure derived from responses to questions included in the 1995 NHS on time felt down, happy, peaceful, and nervous (the SF-36 mental health scale). The second indicator relates to diagnoses of mental disorders including substance use disorders, affective disorders and anxiety disorders. Our final indicator relates to suicidal thoughts and plans and (unsuccessful) suicide attempts. On the basis of these measures, unemployed persons exhibit poorer mental health and wellbeing outcomes than the full-time employed. [source] Prevalence of adverse life events, depression and suicidal thoughts and behaviour among a community sample of young people aged 15,24 yearsAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2001Maria Donald Objective: To provide prevalence data on several key mental health indicators for young people aged 15 to 24 years. Methods: A cross-sectional household survey, using telephone recruitment followed by a postal pencil-and-paper questionnaire. The overall response rate was 67.3%. Results: Difficulties with interpersonal relationships are common causes of distress for young people, in particular problems with parents, problems with friends and relationship break-ups. Depressive symptomatology is common among young people with approximately one in eight males and one in four females reporting current depressive symptomatology. One in three young people reported that they had had suicidal thoughts at some time in the past, 1.2% of young people reported that they had made a plan on how to kill themselves in the four-week period prior to completing the survey and 6.9% of young people reported that they had tried to kill themselves at some time during their life time (4.2% of males and 9.0% of females). Conclusions and implications: The prevalence figures for the various mental health indicators presented in this paper represent good baseline information upon which to examine the progress over time of interventions designed to improve the mental health of young people. [source] Suicidal Behavior in Children Younger than Twelve: A Diagnostic Challenge for Emergency Department PersonnelACADEMIC EMERGENCY MEDICINE, Issue 9 2007Carl 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] | |||||||||||||