Showing papers on "Suicide attempt published in 1986"
TL;DR: The current study provides a linchpin between the studies of adolescent suicide attempt rates and the studies reporting on percentages of adolescents who made suicide attempts, when the percentage of attempters who made attempts but did not seek medical help is taken under consideration.
Abstract: The findings of a pilot study, focusing on suicidal behaviors among 313 high school students in the Midwest, are discussed. Of all the students who participated in the study, 62.6% reported some degree of suicidal ideation or action, including 8.4% who had actually made a suicide attempt. The current study provides a linchpin between the studies of adolescent suicide attempt rates and the studies reporting on percentages of adolescents who made suicide attempts. When the percentage of attempters who made attempts but did not seek medical help is taken under consideration, these two groups of studies become equivalent. Apparently, suicide is a personal concern for most high school students--a problem that warrants immediate attention.
244 citations
TL;DR: In this paper, the relation found to exist between low CSF 5-HIAA and suicide attempt, in particular violent suicide attempt was drawn that decreased central 5-HT metabolism is related to (auto)aggression, rather than to depression.
Abstract: Based on the relation found to exist between low CSF 5-HIAA and suicide attempt, in particular violent suicide attempt, both in depressed and in so-called nondepressed suicide attempters, the conclusion was drawn that decreased central 5-HT metabolism is related to (auto)aggression, rather than to depression. We challenged this conclusion and that for three reasons: Violent suicide attempt accumulates in certain types of depression making it impossible to conclude whether the biological variable relates to (auto)aggression or to that type of depression as such. Nondepressed suicide attempter is a diagnosis that should be based on presuicidal not on postsuicidal data, in order to avoid false-positive diagnoses. Suicide method is not a reliable index of seriousness of the attempt. Risk/rescue ratio should be used instead. Next the data are discussed that do support the hypothesis that diminished 5-HT metabolism in the brain is related to disregulation of aggression. Finally, the hypothesis is launched that both mood and aggression disorders are related to decreased 5-HT metabolism in the CNS. This would provide a biological explanation for the clinical observation that disorders in mood and in aggression often go hand in hand. Biological research of psychiatric disorders gains in informative value as the psychopathological analysis of the phenomena one studies is more comprehensive. Biological suicide research is no exception to this rule.
96 citations
TL;DR: The disparity of characteristics between attempted suicide and definite suicide cases may partly be explained by the preponderance of women among the former and by the fact that only half of the suicidal deaths occurred when the frequency of attempts was at its peak.
Abstract: Of 110 consecutive, young schizophrenic patients, 18 (16.4%) died during a follow-up period of 14-17 years from first admission. Fifteen of them met with a sudden death. Definite suicide was proven in 10 cases (9%). Suicide was associated with chronicity in course, social dependency, and lowered efficiency. Some type of warning was present in all suicide cases. The frequency of suicide thoughts and attempts was high in the whole material. Suicide attempts were associated with protracted non-regressive symptomatology, readmission to hospital, social intervention, and female sex. The disparity of characteristics between attempted suicide and definite suicide cases may partly be explained by the preponderance of women among the former and by the fact that only half of the suicidal deaths occurred when the frequency of attempts was at its peak. In attempted suicide in men their characteristics were compatible with those of the whole group, as well as with those of the suicide cases.
95 citations
TL;DR: Investigation of 40 consecutively admitted suicide attempt patients in an intensive care unit, their therapists, and 70 significant others of 37 of the patients, found ambivalence about helping the patient, and aggression expressed by significant others were most prevalent in the abuse group.
Abstract: Forty consecutively admitted suicide attempt patients in an intensive care unit, their therapists, and 70 significant others of 37 of the patients, were investigated by means of 300 semi-structured interviews. The patients belonged to three diagnostic groups: neurosis, alcohol and drug abuse, and prepsychosis/psychosis. Thirty-seven of the patients had communicated their suicidal intentions to people around them. All patients used protracted indirect verbal communication. Immediately before the suicide attempt, most of the neurotics continued often to indirect verbal communication, amplified by demanding behaviour. Drug and alcohol abusers, moreover, also employed direct verbal communication, and prepsychosis/psychosis patients indirect non-verbal communication. The majority of significant others understood the patients' suicidal communication and responded with near-total silence. Ambivalence about continuing the relationship characterised most partners of patients in all diagnostic groups, and also persons other than partners in the abuse group. Ambivalence about helping the patient, and aggression expressed by significant others were most prevalent in the abuse group.
87 citations
TL;DR: A combination of these two variables yielded a highly significant correlation with type of suicide behavior, both retrospectively and prospectively.
Abstract: • The concentration of 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) and psychophysiologic variables, such as habituation of the skin conductance response, were measured in 35 drug-free, suicidal inpatients. Twentyfour patients were hospitalized after a suicide attempt, and another 11 had suicidal ideation. The suicide attempters were classified into nonviolent (drug overdoses taken orally, or a single wrist cut) and violent (all other methods). As in previous studies, the suicide attempters had significantly lower CSF concentrations of 5-HIAA compared with healthy, matched controls. The distribution of habituation rate was bimodal (slow and fast habituators). All violent attempters were fast habituators, as were all four patients who in a one-year follow-up were found to have completed a suicide (all by violent methods). The lowest frequency of fast habituators was found in the group of patients with suicidal ideation. There was no correlation between CSF 5-HIAA and habituation rate. A combination of these two variables yielded a highly significant correlation with type of suicide behavior, both retrospectively and prospectively.
73 citations
TL;DR: It was concluded that the multiple or “chronic”attempter differed sufficiently from the first-time attempter to warrant special intervention strategies.
Abstract: As part of a study involving seven hundred and forty-seven (747) consecutive cases of self-injury presenting at the emergency department of an inner city hospital, data pertaining to a multiple attempt group of ninety-nine subjects were compared with the data pertaining to first attempters. All subjects were rated on Beck's Lethality Scales, Intent Scale and Hopelessness Scale. In addition, a standard interview was conducted to provide psychosocial information. Of the total suicide attempt population, 14% can be considered chronic. The multiple attempters were found to show more chronicity in their symptomatology, poorer coping histories, a positive family history of suicidal behaviour and a positive history of alcohol and drug abuse, all at a statistically significant level compared with first-time attempters. The multiple attempters also tend to show higher lethality and depression ratings, less impulsiveness and are significantly more often admitted to the in-patient unit following the attempt, than first attempters. Their intent scores were significantly related to their sense of hopelessness, which may be a reflection of their basic feelings of inadequacy. It was concluded that the multiple or "chronic" attempter differed sufficiently from the first-time attempter to warrant special intervention strategies.
50 citations
TL;DR: The data demonstrate the marked responsiveness of measures of aggressive behavior to neuroleptic treatment, suggesting a dopaminergic involvement in these behaviors when observed in the presence of overt psychotic symptoms.
Abstract: In this study of schizophrenic patients, we were unable to find an association between past history of suicide attempt and levels of CSF amine metabolites, response to DST, and ventricular size by CT scan, neurobiologic variables each of which have been reported to be associated with attempted suicide in some patient groups Our data, however, demonstrate the marked responsiveness of measures of aggressive behavior to neuroleptic treatment, suggesting a dopaminergic involvement in these behaviors when observed in the presence of overt psychotic symptoms Some support for an association between decreased CNS serotonin function and aggressive behavior was found in drug-free schizophrenics, although difficulty in separating illness from trait factors is an important confounding variable The need for clinical interventions required to treat severely disturbed and aggressive behavior in the schizophrenic patients studied could not be predicted by any of the neurobiologic variables
42 citations
TL;DR: A systematic survey of in-patient accidents and injuries in an inner London hospital over 9 years established that, after incisions and overdoses, self-incineration was one of the commoner methods of violent self-harm.
Abstract: A systematic survey of in-patient accidents and injuries in an inner London hospital over 9 years established that, after incisions and overdoses, self-incineration was one of the commoner methods of violent self-harm. A case-controlled study of in-patient suicide attempts compared a series of 12 self-incinerators with 12 patients using other methods. Irrespective of method, the suicide attempt was predominantly a psychotic act of young single people with chronic, severe disorders and considerable past parasuicide, in a setting of escalating self-harm. Younger age, greater psychiatric morbidity, absence of alcoholism, a history of childhood arson, past and current self-burning were the features specific to self-incineration, which had a 25% mortality rate.
35 citations
01 Jan 1986
TL;DR: A sample of 151 patients, admitted to an Intensive Care Unit after attempted suicide by poisoning was analysed with regard to age, drugs consumed, possible causal factors and influence of weather, finding a significant positive correlation between the time of attempted suicide and the weather parameters.
Abstract: A sample of 151 patients, admitted to an Intensive Care Unit after attempted suicide by poisoning was analysed with regard to age, drugs consumed, possible causal factors and influence of weather. The German Weather Service provided the meteorological data. Mean age of the patients was 37.6 years. The patients had taken barbiturates, aggressive chemicals, tranquillizers or a combination of drugs (47%). Alcohol had been taken in addition to the drugs in 24%, which might indicate a trigger function. The main provoking causes for the suicide attempts were conflicts in partnerships and occupational problems. Some 15% of the patients had previously diagnosed psychiatric disorders. There was a significant positive correlation between the time of attempted suicide and the weather parameters “stable upslide, labile upslide, fog, thunderstorm, warm air, upslide and weather drier than on the 2 preceding days”. Significantly fewer attempts than expected occurred with “low pressure and trough situation, labile ground layer-upslide above, subsidence or downslide motion”. Apart from individual provoking factors, such as the reaction to conflicts and the spectrum of reactions, exogenous factors like weather must be considered as important for the timing of suicide attempts. These results may be of relevance for suicide prevention.
28 citations
TL;DR: The MMPI demonstrated increased anxiety and decreased ego strength among those with histories of suicide attempts in comparison to those without such a history, and intellectual abilities as evaluated by the WAIS were slightly lower among the suicide attempters.
Abstract: This study evaluated the emotional and intellectual correlates of unsuccessful suicide attempts in persons with seizure disorders. Psychosocial evaluations were completed on 198 adults with epilepsy, of whom 32 had made one or more suicide attempts. The MMPI demonstrated increased anxiety and decreased ego strength among those with histories of suicide attempts in comparison to those without such a history. Intellectual abilities as evaluated by the WAIS were slightly lower among the suicide attempters, especially on language-related tasks. Unsuccessful suicidal behavior in epilepsy is probably the product of multiple conditions and circumstances, including seizures themselves, decreased adaptive abilities, increased emotional problems, and the continual availability of agents (antiepileptic medications) with which a suicide attempt may be undertaken. Language: en
21 citations
TL;DR: Comparisons among patients admitted for a suicide attempt, suicide ideation, or non-suicide-related complaints showed that suicide attempters were more likely to have used alcohol or marijuana and less likely toHave contacted a health care professional than suicide ideators, even when past history of suicide behavior was controlled for.
Abstract: Fifty-nine psychiatric inpatients were interviewed concerning the psychological and environmental events that occurred in the 24 hours prior to their hospitalization. Independent raters then performed a content evaluation of these accounts, allowing for comparisons among patients admitted for a suicide attempt, suicide ideation, or non-suicide-related complaints. Results showed that suicide attempters were more likely to have used alcohol or marijuana and less likely to have contacted a health care professional than suicide ideators, even when past history of suicide behavior was controlled for. Suicide ideators were more likely to have contacted a mental health professional. Implications for suicide risk assessment and intervention are discussed.
TL;DR: This preventive outreach program emphasizes staff training in order to prepare college staff to implement a variety of outreach efforts following the suicide attempt or death of a student on campus.
Abstract: Based on a literature review and a survey of existing programs, this preventive outreach program emphasizes staff training in order to prepare college staff to implement a variety of outreach efforts following the suicide attempt or death of a student on campus. Specific guidelines are offered for the management of the suicide crisis, with special attention focused on the friends of the suicide victim.
TL;DR: Results indicated that irregular discharges, frequent suicide attempts, first suicide attempt prior to age 40, violence within and outside the hospital, and gradual deterioration in social and occupational functioning were found significantly more often in patients with high levels of borderline personality traits.
Abstract: Selected behavioral features felt historically and empirically to be significant in the borderline personality disorder were evaluated in 4,800 psychiatric inpatients. Variables measured included number of hospitalizations and type of discharge, suicidal behavior, physical violence, and outcome after discharge. A statistical analysis was performed to determine the relationship between depth and severity of borderline traits and the aforementioned behavioral features. Results indicated that irregular discharges, frequent suicide attempts, first suicide attempt prior to age 40, violence within and outside the hospital, and gradual deterioration in social and occupational functioning were found significantly more often in patients with high levels of borderline personality traits.
Journal Article•
TL;DR: Patients who have recently been separated or divorced and those who are alcoholic, depressed or previously suicidal are also at risk, and the family physician is in the best position to prevent suicide.
Abstract: Suicide attempts by drug overdose are a growing health care problem, now reaching epidemic proportions. The patient who attempts suicide is typically a young, single adult female with interpersonal conflicts who takes an overdose of a prescribed drug, frequently a benzodiazepine. Patients who have recently been separated or divorced and those who are alcoholic, depressed or previously suicidal are also at risk. The family physician is in the best position to prevent suicide.
TL;DR: There were no significant differences in dysfunctional attitudes between these groups of patients and that their scores were similar to those reported for normal populations, but there was, however, a correlation between introversion and high dysfunctional attitude scores.
Abstract: In order to test the hypothesis that patients who are predisposed to depression have an enduring cognitive style, dysfunctional attitudes (Dysfunctional Attitudes Schedule), neuroticism and extraversion (Maudsley Personality Inventory), and severity of depression (Levine-Pilowsky Depression Questionnaire) were measured in a survey of former patients with previous diagnoses of either depressive or nondepressive psychiatric conditions. We found that there were no significant differences in dysfunctional attitudes between these groups of patients and that their scores were similar to those reported for normal populations. There was, however, a correlation between introversion and high dysfunctional attitude scores. Possible implications regarding interactions between cognitive style, personality, and predisposition toward depression are discussed as well as a suggestion that a history of a suicide attempt may predict a poor response to cognitive psychotherapy.
Journal Article•
TL;DR: Weighted estimates indicated that this group of adult patients admitted to CNPHA-member hospitals were younger than those admitted to other private psychiatric hospitals, almost half had more than one previous psychiatric hospitalization, about one-fourth had made a previous suicide attempt, and two-thirds had engaged in psychotherapy or counseling prior to his admission.
Abstract: A collaborative effort to describe patients at admission led to the development of the Central Data Set, a 32-item profile of demographic and clinical variables which was used to sample 1,302 admissions across 10 hospitals in 1982. Weighted estimates indicated that this group of adult patients admitted to CNPHA-member hospitals were younger than those admitted to other private psychiatric hospitals, almost half had more than one previous psychiatric hospitalization, about one-fourth had made a previous suicide attempt, and two-thirds had engaged in psychotherapy or counseling prior to his admission. Most common diagnoses at admission were major affective disorders (36%), personality disorders (36%), substance abuse (30%), schizophrenic disorders (13%), and depressive neuroses (13%).
01 Jan 1986
TL;DR: The authors argued that there was no evidence of a syndrome of childhood depression because these same symptoms of depression prevail at a rate too high to be considered statistically deviant, and there is no reliable and valid psychometric assessment tool available for use with children.
Abstract: Depression, a clinical diagnosis of long standing in adult psychopathology, has recently emerged as a major diagnostic consideration in the treatment of children. However, disagreement is still widespread among researchers as to the existence of depression in children. As recently as 1978, Lefkowitz and Burton argued that there was no evidence of a syndrome of childhood depression because (a) “these same symptoms of depression prevail at a rate too high to be considered statistically deviant” (p. 724), (b) there is no reliable and valid psychometric assessment tool available for use with children, and (c) the symptoms themselves show marked variation with age and many of them dissipate over time without treatment. The authors warned against precipitous diagnosis of a condition which may not be pathological.
Journal Article•
TL;DR: The authors performed 3 consecutive DSTs in 54 non-endogenous depressives admitted after a suicide attempt and the DST results are not correlated with the lethality of the suicide attempt.
Abstract: The authors performed 3 consecutive DSTs in 54 non-endogenous depressives admitted after a suicide attempt. The DST results are not correlated with the lethality of the suicide attempt. Stress and numerous drug interactions are most probably responsible for the high proportion of DST nonsuppressors among our patients.
Journal Article•
TL;DR: A psychiatric liaison scheme was established at an intensive care unit of the Technical University, Munich in order to intensify the primary psychiatric care of suicide attempters.
Abstract: Only few patients after suicide attempt are examined by a psychiatrist. In order to intensify the primary psychiatric care of suicide attempters, a psychiatric liaison scheme was established at an intensive care unit of the Technical University, Munich. The main advantages are: A psychiatrist talks with every suicide attempter; the psychiatrist and the medical staff are better informed about the suicidal act and the personality of the suicide attempter because of close cooperation; there is more time for diagnostic and psychotherapeutic activities; suicide risk diminishes while staying on the medical ward. If a psychiatric liaison scheme cannot be established it should be tried to change ward atmosphere by advising the medical staff and offering emotional support. Language: de