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Suicide assessment

Peter Flüchter
Suicidality is a complex process with social, individual and medical aspects. Almost every doctor - regardless of discipline - must at some point treat and care for people in suicidal crises. It is important then, to assess the situation correctly and to recognize an acute suicidal risk. Below you will read what to look for and how you can help the patient the best in that difficult situation.
March 2018: Deutsche Medizinische Wochenschrift
Nubia A Mayorga, Charles Jardin, Jafar Bakhshaie, Lorra Garey, Andres G Viana, Jodi Berger Cardoso, Michael Zvolensky
Although recent work has highlighted the relation of acculturative stress with depression and anxiety symptoms specifically among Latino/a university students, the potential mechanisms underlying these associations remain relatively unknown. The present study aims to examine difficulties in emotion regulation as an explanatory factor in the relation of acculturative stress with symptoms of depression, suicidality, social anxiety, and anxious arousal. A sample of 448 Latino/a college students (Mage = 20.67 years, SD = 1...
March 2018: Journal of Counseling Psychology
Juliana Brum Moraes, Michael Maes, Chutima Roomruangwong, Kamila Landucci Bonifacio, Decio Sabbatini Barbosa, Heber Odebrecht Vargas, George Anderson, Marta Kubera, Andre F Carvalho, Sandra Odebrecht Vargas Nunes
Early life trauma (ELT) may increase the risk towards bipolar disorder (BD) and major depression (MDD), disorders associated with activated neuro-oxidative and neuro-nitrosative stress (O&NS) pathways. It has remained elusive whether ELTs are associated with O&NS and which ELTs are associated with distinct affective disorder phenotypes. This case-control study examined patients with BD (n = 68) and MDD (n = 37) and healthy controls (n = 66). The Child Trauma Questionnaire (CTQ) was used to assess specific ELT...
March 14, 2018: Metabolic Brain Disease
Orrin Devinsky, Anup D Patel, Elizabeth A Thiele, Matthew H Wong, Richard Appleton, Cynthia L Harden, Sam Greenwood, Gilmour Morrison, Kenneth Sommerville
OBJECTIVE: To evaluate the safety and preliminary pharmacokinetics of a pharmaceutical formulation of purified cannabidiol (CBD) in children with Dravet syndrome. METHODS: Patients aged 4-10 years were randomized 4:1 to CBD (5, 10, or 20 mg/kg/d) or placebo taken twice daily. The double-blind trial comprised 4-week baseline, 3-week treatment (including titration), 10-day taper, and 4-week follow-up periods. Completers could continue in an open-label extension. Multiple pharmacokinetic blood samples were taken on the first day of dosing and at end of treatment for measurement of CBD, its metabolites 6-OH-CBD, 7-OH-CBD, and 7-COOH-CBD, and antiepileptic drugs (AEDs; clobazam and metabolite N -desmethylclobazam [N-CLB], valproate, levetiracetam, topiramate, and stiripentol)...
March 14, 2018: Neurology
Gin S Malhi, Tim Outhred, Grace Morris, Philip M Boyce, Richard Bryant, Paul B Fitzgerald, Malcolm J Hopwood, Bill Lyndon, Roger Mulder, Greg Murray, Richard J Porter, Ajeet B Singh, Kristina Fritz
In December 2015, the Royal Australian and New Zealand College of Psychiatrists published a comprehensive set of mood disorder clinical practice guidelines for psychiatrists, psychologists and mental health professionals. This guideline summary, directed broadly at primary care physicians, is an abridged version that focuses on bipolar disorder. It is intended as an aid to the management of this complex disorder for primary care physicians working in collaboration with psychiatrists to implement successful long term management...
March 19, 2018: Medical Journal of Australia
Ellen W Blair, Jyoti Chhabra, Cynthia Belonick, Maria Tackett
Potential for suicide risk can be a safety concern for patients in all health care settings. Inadequate training of nurses in suicide assessment and prevention is a serious patient safety concern. A non-randomized pre-/postintervention research design was used to measure the effects of education on non-psychiatric nurses' perceived self-efficacy in assessment and inquiry about suicide risk and in implementing suicide prevention strategies. The intervention was an educational module about suicide prevention and care delivered to non-psychiatric nurses employed on a neuro-trauma unit in an acute care urban hospital setting...
March 14, 2018: Journal of Psychosocial Nursing and Mental Health Services
Jonathan B Imran, Robyn E Richmond, Tarik D Madni, Kimberly Roaten, Audra T Clark, Emily Huang, Ali A Mokdad, Luis R Taveras, Kareem R Abdelfattah, Michael W Cripps, Alexander L Eastman
BACKGROUND: Trauma patients may be at elevated risk for subsequent suicide; however, it is unclear whether patients at risk can be identified during their initial presentation following injury. The objective of this study was to evaluate the use of a standardized clinical decision support system for suicide risk screening developed by our hospital system and to determine the incidence of positive suicide screenings in our trauma population. METHODS: Adult trauma patient screenings were performed by nursing staff during the triage process using the Columbia Suicide Severity Rating Scale, Clinical Practice Screener, Recent (C-SSRS)...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Kate H Thomas, Justin T McDaniel, David L Albright, Kari L Fletcher, Harold G Koenig
Suicide rates among military veterans exceed those found in the general population. While the exact reasons for these high rates are unknown, contributing factors may include the military's perceived rejection of patient identities, creating barriers to mental health care within the clinical sector and a mandate for prevention programs. Spiritual fitness has emerged over the last decade as an important concept in human performance optimization and is included among holistic approaches to developing and maintaining mentally fit fighting forces...
March 13, 2018: Journal of Religion and Health
David W Morris, Subroto Ghose, Ella Williams, Kevin Brown, Fuad Khan
Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202)...
2018: Neuropsychiatric Disease and Treatment
Leila Jansson, Ulla Hällgren Graneheim
This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress...
March 13, 2018: Issues in Mental Health Nursing
David J Cottrell, Alex Wright-Hughes, Michelle Collinson, Paula Boston, Ivan Eisler, Sarah Fortune, Elizabeth H Graham, Jonathan Green, Allan O House, Michael Kerfoot, David W Owens, Eirini-Christina Saloniki, Mima Simic, Sandy Tubeuf, Amanda J Farrin
BACKGROUND: Self-harm in adolescents is common and repetition rates high. There is limited evidence of the effectiveness of interventions to reduce self-harm. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of family therapy (FT) compared with treatment as usual (TAU). DESIGN: A pragmatic, multicentre, individually randomised controlled trial of FT compared with TAU. Participants and therapists were aware of treatment allocation; researchers were blind to allocation...
March 2018: Health Technology Assessment: HTA
David Boulos, Deniz Fikretoglu
OBJECTIVE: The primary objective was to explore differences in mental health problems (MHP) between serving Canadian Armed Forces (CAF) components (Regular Force (RegF); Reserve Force (ResF)) with an Afghanistan deployment and to assess the contribution of both component and deployment experiences to MHP using covariate-adjusted prevalence difference estimates. Additionally, mental health services use (MHSU) was descriptively assessed among those with a mental disorder. DESIGN: Data came from the 2013 CAF Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629)...
March 12, 2018: BMJ Open
Sanne Verkooijen, Nelleke de Vos, Betty J W Bakker-Camu, Susan J T Branje, René S Kahn, Roel A Ophoff, Carolien M Plevier, Marco P M Boks
OBJECTIVE: To investigate the prevalence of adolescent sleep disturbances and their relation with psychosocial difficulties and health risk behaviours we analysed data of a province-wide health survey (n=16,781). METHODS: Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality and health risk behaviours including current use of tobacco, alcohol and drugs, physical inactivity and compulsive use of multimedia...
March 9, 2018: Academic Pediatrics
Samuel Mullinax, Christen E Chalmers, Jesse Brennan, Gary M Vilke, Kimberly Nordstrom, Michael P Wilson
BACKGROUND: Suicide screening scales have been advocated for use in the ED setting. However, it is currently unknown whether patients classified as low-risk on these scales can be safely discharged from the emergency department. This study evaluated the utility of three commonly-used suicide screening tools in the emergency department to predict ED disposition, with special interest in discharge among low-risk patients. METHODS: This prospective observational study enrolled a convenience sample of patients who answered "yes" to a triage suicidal ideation question in an urban academic emergency department...
January 31, 2018: American Journal of Emergency Medicine
Silvia Ronzitti, Shane W Kraus, Rani A Hoff, Massimo Clerici, Marc N Potenza
BACKGROUND: Despite the strong associations between personality disorders and problem/pathological gambling, few studies have investigated the relationships between personality disorders, problem-gambling severity and suicidal thoughts/behaviors. OBJECTIVES: We examined the relationships between problem-gambling severity and personality disorders among individuals with differing levels of suicidality (none, thoughts alone, attempts). METHODS: We analyzed data from 13,543 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) study...
March 5, 2018: Addictive Behaviors
Julie Lutz, Barry Edelstein, Emma Katz, Jarred V Gallegos
Background and Objectives: Older adults have elevated suicide rates, and identification of protective factors, such as reasons for living, is important in preventing suicide. The Reasons for Living-Older Adults scale (RFL-OA) is a 69-item measure of these protective factors in late life, which yields good psychometric properties. However, its length limits its utility in some clinical and research contexts where a shorter measure is ideal. The objective of this study was to create a shortened version of the RFL-OA...
February 26, 2018: Gerontologist
Matthew K Nock, Alexander J Millner, Thomas E Joiner, Peter M Gutierrez, Georges Han, Irving Hwang, Andrew King, James A Naifeh, Nancy A Sampson, Alan M Zaslavsky, Murray B Stein, Robert J Ursano, Ronald C Kessler
Prior research has shown that most known risk factors for suicide attempts in the general population actually predict suicide ideation rather than attempts among ideators. Yet clinical interest in predicting suicide attempts often involves the evaluation of risk among patients with ideation. We examined a number of characteristics of suicidal thoughts hypothesized to predict incident attempts in a retrospective analysis of lifetime ideators (N = 3,916) drawn from a large (N = 29,982), representative sample of United States Army soldiers...
February 2018: Journal of Abnormal Psychology
Beth S Brodsky, Aliza Spruch-Feiner, Barbara Stanley
Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice...
2018: Frontiers in Psychiatry
Shannon M Blakey, H Ryan Wagner, Jennifer Naylor, Mira Brancu, Ilana Lane, Meghann Sallee, Nathan A Kimbrel, Eric B Elbogen
The polytrauma clinical triad refers to the co-occurrence of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD). Despite research implicating dyadic relationships between these conditions and adverse outcomes, scant research has examined the polytrauma clinical triad's relation to suicide or violence. The present cross-sectional study was designed to examine whether this complex clinical presentation increases risk of suicidal ideation and violent impulses after accounting for other established risk factors...
March 8, 2018: Journal of Pain: Official Journal of the American Pain Society
Asghar Ghasemi, Morteza Seifi, Bahram Samadi Rad
AIM: Several studies have assessed a relationship between 5-hydroxytryptamine (serotonin) 2A receptor (5-HTR2A) gene polymorphisms with an increased risk of suicidal behavior. However, there has been no study about the association between 5-HTR2A gene polymorphisms, suicidal behavior, stressful life and loss events in a same time. METHODS: 5-HTR2A polymorphisms in a total of 191 suicide victims and 218 healthy controls were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)...
March 8, 2018: Gene
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