A neurosciences based – semiology of suicidal behavior

2016 ◽  
Vol 33 (S1) ◽  
pp. S49-S49
Author(s):  
P. Courtet
Keyword(s):  
Suicidal Behavior ◽  
Sleep Time ◽  
Warning Signs ◽  
Current Evidence ◽  
Emotional States ◽  
Sedentary Behaviors ◽  
Psychological Pain ◽  
The Family ◽  
Competing Interest ◽  
To Receive

The epidemiology, risk factors and biological basis of suicidal behaviors have been the object of an ever-increasing research in the last three decades. During this period, researchers all over the world have identified potential biomarkers of risk and developed several theories about the mechanisms leading to suicidal behavior. However, the lack of common terminology, instruments and cooperation has been a major deterrent. Today, the community has established the bases for this collaboration and evidence coming from neuroscientific studies can already be applied to the field of suicidology. We present here a potential semiology based on current evidence coming from biological, clinical and neuroimaging studies. Besides suicidal ideation and warning signs, the clinical features related to suicide risk and revealed by neuroscientific studies include notably: impulsive-aggression and hopelessness as well as high web consumption, sedentary behaviors and reduced sleep time, an enhanced sensibility to social exclusion and loneliness, a decreased sensitivity to detect social support, interpersonal problems related to decision-making impairments, difficulties to regulate negative emotional states, a propensity to perceive psychic and also physical pain and to receive opiates treatments. Improving the assessment will also open new targets for suicide prevention. In the short-term, some of these targets await us: standard protocols for evaluation of risk, healthcare continuity, implication of the family/caregivers, mitigation of social or psychological pain.Disclosure of interestThe author has not supplied his declaration of competing interest.

Clinical Use of Biomarkers in Suicidal Behaviors

2017 ◽  
Vol 41 (S1) ◽  
pp. S41-S41
Author(s):  
P. Courtet
Keyword(s):  
Risk Factors ◽  
Suicidal Behavior ◽  
Current Evidence ◽  
Clinical Use ◽  
Suicidal Behaviors ◽  
Biological Basis ◽  
The World ◽  
Competing Interest ◽  
Potential Biomarkers

The epidemiology, risk factors, and biological basis of suicidal behaviors have been the object of an ever–increasing research in the last three decades. During this period, researchers all over the world have identified potential biomarkers of risk and developed several theories about the mechanisms leading to suicidal behavior. However, the lack of common terminology, instruments, and cooperation has been a major deterrent. Today, the community has established the bases for this collaboration and evidence coming from neuroscientific studies can already be applied to the field of suicidology. We present here a potential semiology based on current evidence coming from biological, clinical, and neuroimaging studies.Disclosure of interestThe author declares that he has no competing interest.

A systematic review of association between pain and suicidal behavior in elderly people

2017 ◽  
Vol 41 (S1) ◽  
pp. S174-S174
Author(s):  
J. Santos ◽  
S. Martins ◽  
L.F. Azevedo ◽  
L. Fernandes
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Risk Factor ◽  
Elderly People ◽  
Suicidal Behavior ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Late Life ◽  
Psychological Pain ◽  
Competing Interest

IntroductionSuicide rates worldwide are highest in elderly people compared to younger ages. The recognition of risk factors for late life suicide may be crucial, since one in four attempts is consummated. In this context, pain has been identified as a major event raising the probability for suicide in elders although very little research has examined this association.ObjectiveTo conduct a systematic review to examine whether pain is a risk factor for suicidal behaviour (suicide ideation/attempt/suicide) in elderly people.MethodsThe Cochrane Collaboration's guidelines and PRISMA statement were used. The electronic databases considered were MEDLINE, ISI Web of Knowledge, Scopus and PsycARTICLES. Search terms were “pain”, “suicide*” and “elderly”. Studies that assessed the relation between pain and suicidal behavior among people aged ≥ 60 years were included.ResultsOf the 2655 references founded, only 41 articles met the inclusion criteria. Most of the quantitative studies concluded that there is a relationship between pain and late life suicidal ideation, in particular severe and chronic pain. Physical or psychological pain was also reported as the cause of attempting suicide in two studies and was considered an important risk factor for committed suicide in eight of them.ConclusionThe results suggest that pain is a risk factor for suicidal behaviour in elderly people, especially suffering from severe and chronic pain, which are in accordance with previous reviews in this field. Future studies are needed to clarify this association and highlight about the importance of pain in suicide prevention initiatives for elders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychological pain and interpersonal theory of suicide

2016 ◽  
Vol 33 (S1) ◽  
pp. S22-S22
Author(s):  
A. Apter
Keyword(s):  
Suicide Prevention ◽  
Suicidal Behavior ◽  
Empirical Studies ◽  
Important Variable ◽  
Interpersonal Theory ◽  
Prevention Strategies ◽  
Psychological Pain ◽  
Interpersonal Theory Of Suicide ◽  
Competing Interest ◽  
Set Up

Psychological pain is an important variable in the understanding of suicidal individual.This presentation describes the how psychological pain interacts with problems in communication to set up risk for serious suicidal behavior and describes some empirical studies supporting a model for using this concept in suicide prevention strategies.Disclosure of interestThe author has not supplied his declaration of competing interest.

What Predicts the Use of Blended Sentences Among Eligible Juveniles? A State-Wide Examination

2021 ◽  
pp. 088740342110282
Author(s):  
Jessica M. Craig ◽  
Haley Zettler ◽  
Chad Trulson
Keyword(s):  
Juvenile Justice ◽  
Violent Offenders ◽  
Criminal Sanctions ◽  
Adult Court ◽  
The Family ◽  
To Receive ◽  
Blended Sentencing

In response to critiques of traditional juvenile justice processing and waiver to adult court, several states have adopted blended sentencing. These sentences fall in between these two approaches as they offer the benefits of the more rehabilitative-oriented juvenile system, with the option to deploy more punitive adult criminal sanctions. While previous research has indicated violent offenders were more likely to receive a blended sentence, it has not distinguished between those who were eligible for a blended sentence but did not receive this sanction. The current study seeks to address this gap and examine legal and extralegal predictors of receiving a blended sentence among those eligible. The analyses indicated that while those adjudicated for homicide and aggravated robbery were most likely to be given a blended sentence, other predictors such as prior probation failure and previous violence toward the family were associated with a decreased likelihood of receiving this sentence.

Suicide attempt in alcohol use disorder and Wernicke encephalopathy: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S599-S599
Author(s):  
L. Espinosa ◽  
A. Fortea ◽  
G. Oriolo ◽  
M. Balcells ◽  
C. Oliveras
Keyword(s):  
Risk Factor ◽  
Alcohol Use ◽  
Suicidal Behavior ◽  
Alcohol Use Disorder ◽  
Blood Analysis ◽  
Wernicke Encephalopathy ◽  
Suicidal Attempts ◽  
Competing Interest ◽  
Concomitant Condition ◽  
Image Volume

BackgroundThe relation between alcohol dependence and suicidal behavior is well known and alcohol consumption is a risk factor to take in consideration in order to prevent suicidal attempts. Wernicke encephalopathy (WE) is a common acute neurological disorder caused by thiamine deficiency frequently associated with alcohol use disorder and often infra-diagnosed. Just few cases are reported about the possible correlation between suicidal behaviour and Wernicke encephalopathy.ObjectiveTo describe the possible association between suicidal attempts and Wernicke encephalopathy.MethodsWe report the case of a 57 year old man, with past diagnosis of disthymia and amphetamine abuse disorder, and a history of bariatric surgery, who was hospitalized in the intensive care unit (ICU) of hospital clinic for a suicidal attempt by mean of metro railway precipitation. He presented two episodes of psychomotor agitation in the context of an abstinence syndrome that reverted with midazolam continuous perfusion and clonazepam 8 mg per day. Consequently to medical improvement, he was moved to Psychiatry Unit of Addictive Behavior and finally diagnosed with alcohol use disorder.ResultsIn the physical exam, bilateral nystagmus and cerebellar ataxia were observed. Signs of malnutrition were detected in the blood analysis. In a brain magnetic resonance image, volume deficits in the mammillary bodies, thalamus, cortex and corpus callosum, as well as peri-aqueductal altered signal were observed, all signs compatible with Wernicke encephalopathy diagnoses.ConclusionsWernicke encephalopathy is a frequent concomitant condition in patients with alcohol use disorder. The consequent cognitive decline could represent an independent added risk factor for suicidal behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anti-craving biofeedback program in clinical course of pathological addictions

2017 ◽  
Vol 41 (S1) ◽  
pp. s879-s879
Author(s):  
I. Sosin ◽  
Y. Chuev ◽  
A. Volkov ◽  
O. Goncharova
Keyword(s):  
Individual Preference ◽  
Emotional States ◽  
Digital Information ◽  
External Monitoring ◽  
Computer Testing ◽  
Mode Of Life ◽  
Competing Interest ◽  
The Individual ◽  
Monitoring Module ◽  
And Control

IntroductionModern clinical narcology searches for anti-craving programs to overcome psychoactive substances (PAS) pathological addiction with bio-adaptive regulation of systems (BARS).Aims and objectivesTo develop computer modified biofeedback program integrated with Luscher test.MethodTwenty-two PAS addicts who were undergoing biofeedback modified psycho-training were examined. Computer rheoencephalogram (REG) was used as an external monitoring module.ResultsTechnologically novel biofeedback computer modification was developed with preceding Luscher computer testing for determination of the individual preference colour and the colour producing individual unpleasant associations in respondents. Consequently, biofeedback program was corrected differentially by changing standard colour templates for those personified on monitor. Cerebral hemodynamics condition transferred to individually designed for a particular respondent colour registers is used as a homeostatic parameter reflecting alcohol craving presence/absence: in case of the disordered REG parameters the signal reflects the respondent's unpleasant (negative) colour, and with no craving the screen is filled with positive, pleasant, favourite colour. During BARS auto-training the respondents’ skills to mediate present subjective clinical PAS craving manifestations with unpleasant colour and the experimental auto-training method have been mastered, and those psycho emotional states which displace PAS craving symbolic colour from the screen are selected, and it is substituted with favourite colour (symbol of healthy mode of life motivations).ConclusionsUsage of combined BARS biofeedback improved effectiveness of the training and allowed to objectivize and control the condition of the patient getting reliable visual and digital information about either regress or activation of PAS craving and potential relapse of addictive behaviour.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S311-S311
Author(s):  
F. Pavez Reyes ◽  
M. Sánchez ◽  
E. Moral ◽  
M. Terradillos ◽  
N. López ◽  
...  
Keyword(s):  
Case Report ◽  
Alcohol Dependence ◽  
Cerebellar Atrophy ◽  
Clinical Suspicion ◽  
Gamma Glutamyl Transferase ◽  
The Family ◽  
Other Information ◽  
Diagnostic Hypothesis ◽  
Competing Interest ◽  
Glutamyl Transferase

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Availability and accessibility of medications and toxic substances and suicidal behavior

2016 ◽  
Vol 33 (S1) ◽  
pp. S596-S596
Author(s):  
M. Arsenyan ◽  
S. Sukiasyan ◽  
T. Hovhannisyan
Keyword(s):  
Suicidal Behavior ◽  
Significant Influence ◽  
Crucial Role ◽  
Attempted Suicide ◽  
Conflict Situation ◽  
Toxic Substances ◽  
Suicide Method ◽  
Teenage Girls ◽  
Competing Interest ◽  
Suicidal Crisis

IntroductionScientific research indicates that accessibility of suicide means has a significant influence on the choice of method. Since the choice of suicide method largely depends on availability of suicide means, the lethality of method at hand plays a crucial role in a period of suicidal crisis.AimsWe aimed to reveal the associations between accessibility and availability of medications and toxic substances and suicidal behavior of teenage girls in Armenia.ObjectiveOur objectives were to determine whether accessibility and availability of medications and toxic substances have any impact on development of suicidal behavior among teenage girls in Armenia and whether toxicity and quantity of medications and toxic substances at hand or purchased by attempters are associated with severity of outcome.MethodsA qualitative analysis of patient histories of 26 teenage girls, hospitalized in the ICU, Toxicology Center “Muratsan”, Yerevan, RA, diagnosed as having acute deliberate self-poisoning was performed.ResultsIn majority of cases, conflict situation preceded suicidal behavior and decision on attempting suicide was impulsive. Being emotionally distressed teenage girls reached for medications and toxic substances readily available in the household or bought medications from a pharmacy.ConclusionThe vast majority of teenage girls attempted suicide by medications and toxic substances at hand. Admittedly, both, type of medication and quantity of pills or amount of toxic substances utilized, affected the severity of outcome. Hence, the availability and accessibility of medications and toxic substances played a crucial role in development of suicidal behavior and severity of outcome.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Future direction of suicidal risk assessment

2016 ◽  
Vol 33 (S1) ◽  
pp. S68-S68
Author(s):  
H. Blasco-Fontecilla
Keyword(s):  
At Risk ◽  
Suicidal Behavior ◽  
Suicidal Risk ◽  
Sources Of Information ◽  
Future Directions ◽  
Suicide Prediction ◽  
Competing Interest ◽  
Future Direction ◽  
Near Future ◽  
Subjective Reports

Objectiveto explore future directions on the assessment of the risk of suicidal behavior (SB).Methodsnarrative review of current and future methods to improving the assessment of the risk of suicidal behavior (SB).ResultsPredicting future SB is a long-standing goal. Currently, the identification of individuals at risk of SB is based on clinician's subjective reports. Unfortunately, most individuals at risk of SB often do not disclose their suicidal thoughts. In the near future, predicting the risk of SB will be enhanced by: (1) introducing objective, reliable measures – i.e. biomarkers – of suicide risk; (2) selecting the most discriminant variables, and developing more accurate measures – i.e. questionnaires – and models for suicide prediction; (3) incorporating new sources of information – i.e. facebook, online monitoring; (4) applying novel methodological instruments such as data mining, or computer adaptive testing; and, (5) most importantly, combining predictors from different domains (clinical, neurobiological and cognitive).ConclusionsGiven the multi-determined nature of SB, a combination of clinical, neuropsychological, biological, and neuroimaging factors, among other might help overcome current limitations in the prediction of SB. Furthermore, given the complexity of prediction of future SB, currently our efforts should be focused on the prevention of SB.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Turismo de células madre

2012 ◽  
Vol 61 (1) ◽  
Author(s):  
José Luis Pérez Requejo ◽  
Justo Aznar Lucea
Keyword(s):  
Medical Tourism ◽  
Family Doctor ◽  
Medical Support ◽  
Sono Stati ◽  
Advanced Therapy ◽  
The Family ◽  
Scientific Papers ◽  
Seriously Ill Patients ◽  
To Receive ◽  
Seriously Ill

Mai prima d’ora i pazienti gravemente malati o con malattie incurabili o croniche, sono stati così esposti a organizzazioni mediche senza scrupoli, che approfittando del loro logico disagio e della loro preoccupazione promettono cure miracolose e trattamenti, facendo pagare enormi somme di denaro per procedure senza alcuna garanzia, alcun reale beneficio e, peggio ancora, con gravi rischi per la salute. Questo articolo discute alcuni casi di pazienti che hanno pagato con la loro salute, spesso irrimediabilmente, o in maniera catastrofica, gli effetti di terapie teoricamente avanzate con cellule staminali di alcuni centri. Ci si è riferiti a diversi paesi che, in tempi anche non remoti, offrono e praticano qualcuno di questi trattamenti, il più delle volte attraverso strategie di marketing dirette e aggressive per i pazienti o le loro famiglie, mostrando reale o fittizi rapporti relativi ad altri pazienti, ma senza previ studi scientifici che avvalorino i risultati dei presunti benefici. In questo articolo, discutiamo alcuni utili suggerimenti e linee guida internazionali per riconoscerli ed evitarli. Inoltre, abbiamo discusso in dettaglio le ragioni specifiche per cui la maggior parte dei medici e clinici sollevino dei dubbi sulla competenza e le ragioni etiche di questi centri e scoraggino i viaggi di questo “turismo medico”. È sempre consigliabile chiedere il consiglio del medico di famiglia o specialista, prima della decisione dei pazienti di ricevere trattamenti dubbi, con la certezza che il paziente avrà sempre la sua comprensione e il supporto emotivo e medico. ---------- Never before seriously ill patients with chronic or incurable diseases have been so exposed to unscrupulous medical organizations that, taking advantage of their logical distress and worry, promise miracle cures and treatments and charge them huge amounts of money for procedures with no guarantee, no real benefits and, even worse, with serious risks to their health. This paper discusses some cases of patients who paid with their health, often irreparably, or catastrophically, the effects of supposedly advanced therapy centers with stem cells. Several countries are mentioned, not always as remote, which offer and practice any of these treatments, most often by direct and aggressive marketing to patients or their families, showing real or fictional accounts of other patients, but without the previous studies and scientific papers that endorse their supposed beneficial results. In this article we discuss some useful hints and international guidelines to recognize and avoid them. Also, we discussed in detail the specific reasons why most doctors and clinics doubt about the competence and ethical reasons of these centers and discourage those “medical tourism” trips. It is always advisable to seek the advice of the family doctor or specialist in charge, before the patients decision to receive dubious treatments, with the assurance that, decide what the patient decide, they will have always his understanding and his emotional and medical support.

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