Electrodermal hyporeactivity evaluation for detecting suicidal propensity in depressed patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S68-S69
Author(s):  
L.H. Thorell
Keyword(s):  
Suicide Risk ◽  
Statistical Approach ◽  
Strong Relationship ◽  
Risk Assessments ◽  
Suicidal Risk ◽  
Tone Stimulus ◽  
Depressed Patients ◽  
Electrodermal Reactivity ◽  
Competing Interest ◽  
Commit Suicide

IntroductionSince 1987 several publications have focused on electrodermal reactivity in groups with different suicidal behaviors, but with varying results. However, using an untraditional statistical approach with clinical application in focus revealed between themselves confirming results of a strong relationship between electrodermal hyporeactivity and suicide.ObjectivesThe objectives were to investigate how this research tool can be implemented for detecting suicide risk in depressed patients.AimsThe aims were to find a base for the objective test of electrodermal reactivity to be used as support in suicidal risk assessments in depressed patients.MethodsMore than ten published studies on electrodermal hyporeactivity and suicide were reviewed subsequent to the application of an untraditional statistical approach. Gender, age,subdiagnoses and depressive depth were considered. All subjects were tested in a habituation experiment of the electrodermal response to a moderately strong tone stimulus.ResultsThe percentage of electrodermally hyporeactive depressed patients who later committed suicide was 86–97%. The percentage of electrodermally reactive patients that did not commit suicide was 96–98%. Hyporeactivity seems to be stable in at least 1–2 years in remission.ConclusionsIt was considered favorable to test for hyporeactivity as early as possible, i.e. already in the primary care. That enables right treatment of right patients very early. The number of referrals to psychiatric specialists could be expected to decrease. Possible causes of hyporeactivity begin to be revealed, giving ideas of several treatment approaches.Disclosure of interestThe author has not supplied his declaration of competing interest.

What is commonly missed in the suicidal risk assessments in the emergency room?

2017 ◽  
Vol 41 (S1) ◽  
pp. S562-S562
Author(s):  
N. Alavi ◽  
T. Reshetukha ◽  
E. Prost ◽  
A. Kristen ◽  
D. Groll
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Emergency Medicine ◽  
Emergency Room ◽  
Educational Intervention ◽  
Suicide Risk ◽  
Chart Review ◽  
Risk Assessments ◽  
Suicidal Risk ◽  
Suicide Risk Assessment

IntroductionSuicidal behaviour remains the most common reason for presentation to the emergency rooms. In spite of identifiable risk factors, suicide remains essentially unpredictable by current tools and assessments. Moreover, some factors may not be included consistently in the suicidal risk assessments in the emergency room by either emergency medicine physicians or psychiatrists.MethodStep 1 involved the administration of a survey on the importance of suicide predictors for assessment between psychiatry and emergency medicine specialties. In step 2 a chart review of psychiatric emergency room patients in Kingston, Canada was conducted to determine suicide predictor documentation rates. In step 3, based on the result of the first 2 steps a suicide risk assessment tool (Suicide RAP [Risk Assessment Prompt]) was developed and presented to both teams. A second patient chart review was conducted to determine the effectiveness of the educational intervention and suicide RAP in suicide risk assessment.ResultsSignificant differences were found in the rating of importance and the documentation rates of suicide predictors between the two specialties. Several predictors deemed important, have low documentation rates. Thirty of the suicide predictors showed increased rates of documentation after the educational intervention and the presentation of the suicide RAP.ConclusionThough a surfeit of information regarding patient risk factors for suicide is available, clinicians and mental health professionals face difficulties in integrating and applying this information to individuals. Based on the result of this study suicide RAP and educational intervention could be helpful in improving the suicidal risk assessment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Suicidal risk in depressive patients

2003 ◽  
Vol 56 (1-2) ◽  
pp. 76-79 ◽  
Author(s):  
Mina Cvjetkovic-Bosnjak ◽  
Branislava Soldatovic-Stajic
Keyword(s):  
Rating Scale ◽  
Psychiatric Clinic ◽  
Suicidal Risk ◽  
Discriminate Analysis ◽  
Suicidal Thoughts ◽  
Depressed Patients ◽  
Novi Sad ◽  
Depressive Patients ◽  
Risk Scale ◽  
Commit Suicide

Introduction The purpose of this study was to examine the suicidal risk in regard to suicidal thoughts, ideas and attempts among delusional and non-delusional depressed patients. Material and methods 35 non-delusional and 30 delusional depressed patients were examined. All patients were hospitalized at the Psychiatric Clinic in Novi Sad, between 1995-2001. In regard to statistical methods t-test and multivariate discriminate analysis were used. Results Delusional depressives were older. They presented greater scores both on Hamilton Depressive Rating Scale and Beck Scale of Suicidal Thoughts. They were also at greater suicidal risk measured by Suicidal Risk Scale (M.Biro). However, delusional depressive patients plan suicide more carefully than non-delusional. Discussion and conclusion Patients with self-accusing ideas commit suicide most frequently. Delusional depressive patients were at higher suicidal risk; their suicidal thoughts were more intensive than in non-delusional patients; similar results were found in other articles as well.

The Link Between Sleep, Stress and BDNF

2017 ◽  
Vol 41 (S1) ◽  
pp. S282-S282 ◽  
Author(s):  
A. Eckert ◽  
S. Karen ◽  
J. Beck ◽  
S. Brand ◽  
U. Hemmeter ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Serum Levels ◽  
Bdnf Expression ◽  
Depressed Patients ◽  
Level Increase ◽  
Stress Experience ◽  
Partial Sleep Deprivation ◽  
Competing Interest ◽  
Fast Increase ◽  
Serum Bdnf

The protein brain derived neurotrophic factor (BDNF) is a major contributor to neuronal plasticity. There is numerous evidence that BDNF expression is decreased by experiencing psychological stress and that accordingly a lack of neurotrophic support causes depression. The use of serum BDNF concentration as a potential indicator of brain alteration is justified through extensive evidence. Recently, we reported, for the first time, a relationship between BDNF and insomnia, since we could show that reduced levels of serum BDNF are correlated with sleep impairment in control subjects, while partial sleep deprivation was able to induce a fast increase in serum BDNF levels in depressed patients. Using a bi-directional stress model as an explanation approach, we propose the hypothesis that chronic stress might induce a deregulation of the HPA system leading in the long term to sleep disturbance and decreased BDNF levels, whereas acute sleep deprivation, can be used as therapeutical intervention in some insomniac or depressed patients as compensatory process to normalize BDNF levels. Indeed, partial sleep deprivation (PSD) induced a very fast increase in BDNF serum levels within hours after PSD which is similar to effects seen after ketamine infusion, another fast-acting antidepressant intervention, while traditional antidepressants are characterized by a major delay until treatment response as well as delayed BDNF level increase. Moreover, we revealed that stress experience and subjective sleep perception interact with each other and affect serum BDNF levels. We identified sleep as a mediator of the association between stress experience and serum BDNF levels.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 Climate variations: Risk factor of commiting suicide

2011 ◽  
Vol 64 (3-4) ◽  
pp. 202-205 ◽  
Author(s):  
Caslav Milic ◽  
Sanja Kocic ◽  
Snezana Radovanovic
Keyword(s):  
Suicide Rate ◽  
Atmospheric Pressure ◽  
Early Summer ◽  
The Sun ◽  
Climate Factors ◽  
Climate Variations ◽  
Suicidal Risk ◽  
Wind Climate ◽  
Commit Suicide ◽  
Number Of Authors

Introduction. Recently there have been more and more attempts at getting into connection the frequency of suicide with climate factors, humidity changes, atmospheric pressure. A large number of authors agree that suicide has meteorological character and that weather can be a provoking factor in suicidal persons. Suicides happen most frequently when the weather is warm, stable, and sunny; then, when it is rainy, cloudy and with high humidity, and least frequently when the atmospheric pressure and temperature are decreased accompanied with wind. Climate variations and suicide. Men who commit suicide show a significant, positive connection with indicators of temperature and exposure to sun, and a significant, negative connection with indicators of humidity and rainfall. Women who commit suicide show a less significant connection with climate variations - indicators. Violent and non-violent suicide. Regarding violent and nonviolent suicide, it has been proved that violent suicide is affected by environmental temperature, sunny intervals, raise in temperature in the previous few weeks. Higher envi?ronmental temperature and increase in air temperature in the previous few weeks are the most significant climate factors influencing the violent suicide rate. In addition, each degree exceeding 18?C increases the violent suicide rate by 3.8-5%. Conclusion. The result of many investigations of the influence of climate factors on committing suicide is that the suicide incidence reaches its peak during early summer. Also, the sun radiation the day before suicidal event is significantly connected with the increased suicidal risk. There is a difference between sexes. If the sun were a trigger, men would have to be exposed to it for a longer time than women.

Suicide in Foster Care: A High-Priority Safety Concern

2020 ◽  
Vol 15 (3) ◽  
pp. 665-668
Author(s):  
Lily A. Brown
Keyword(s):  
Foster Care ◽  
Behavioral Health ◽  
Suicide Risk ◽  
Safety Concern ◽  
Contextual Information ◽  
The United States ◽  
Case Managers ◽  
Risk Assessments ◽  
Health Providers ◽  
Suicide Screening

Suicide rates among youths in foster care are among the highest in the United States. Despite this fact, many foster-care agencies do not perform universal suicide-risk assessments as part of routine care. This commentary includes an argument for the importance of implementing universal suicide-risk assessments for youths in foster care. Important contextual information that prevents behavioral-health clinicians from implementing universal suicide screenings of youths in foster care is discussed. Several possible strategies for implementing universal suicide-risk assessments are offered; the pros and cons of each strategy are discussed. The perspectives of multiple stakeholders should be included in the consideration of universal suicide screening for youths in foster care, including behavioral-health providers, primary-care doctors, supervisors, directors of agencies, foster parents, and case managers. Although each of these stakeholders can improve suicide prevention, youths in foster care may not have regular access to each stakeholder. Case managers may be the optimal stakeholders for implementing universal suicide screening because of their frequent access to youths in foster care; therefore, case managers should receive training in suicide-risk assessment and prevention strategies.

Analysis of Vocal Tract Characteristics for Near-term Suicidal Risk Assessment

2004 ◽  
Vol 43 (01) ◽  
pp. 36-38 ◽  
Author(s):  
A. Ozdas ◽  
D. M. Wilkes ◽  
M. K. Silverman ◽  
S. E. Silverman ◽  
R. G. Shiavi
Keyword(s):  
Vocal Tract ◽  
Classification Performance ◽  
Gaussian Mixtures ◽  
Suicidal Risk ◽  
Depressed Patients ◽  
Discriminating Power ◽  
Cepstral Coefficients ◽  
Near Term ◽  
The Many ◽  
Suicidal Patients

Summary Objectives: Among the many clinical decisions that psychiatrists must make, assessment of a patient’s risk of committing suicide is definitely among the most important, complex and demanding. One of the authors reviewing his clinical experience observed that successful predictions of suicidality were often based on the patient’s voice independent of content. The voices of suicidal patients exhibited unique qualities, which distinguished them from non-suicidal patients. In this study we investigated the discriminating power of lower order mel-cepstral coefficients among suicidal, major depressed, and non-suicidal patients. Methods: Our sample consisted of 10 near-term suicidal patients, 10 major depressed patients, and 10 non-depressed control subjects. Gaussian mixtures were employed to model the class distributions of the extracted features. Results and Conclusions: As a result of two-sample ML classification analyses, first four mel-cepstral coefficients yielded exceptional classification performance with correct classification scores of 80% between near-term suicidal patients and non-depressed controls, 75% between depressed patients and non-depressed controls, and 80% between near-term suicidal patients and depressed patients.

Characteristics of suicide attempters with a high lethality means

2017 ◽  
Vol 41 (S1) ◽  
pp. s889-s889
Author(s):  
C.T. Lee ◽  
S.Y. Lee ◽  
K.U. Lee ◽  
H.K. Lee ◽  
Y.S. Kweon
Keyword(s):  
Clinical Judgment ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Demographic Variables ◽  
Suicide Attempters ◽  
Exact Test ◽  
Factors Associated ◽  
History Of ◽  
Competing Interest ◽  
Lethal Means

IntroductionSuicide attempts with higher lethality increase the likelihood of suicide completion. Accumulating knowledge on risk factors contributing to higher suicide lethality may help clinicians to allocate their limited resources to more endangered people.ObjectivesTo explore the factors associated with higher lethality in suicide attempts.MethodsAll suicide attempters, who visited the emergency department of Uijeongbu St. Mary's hospital from January 2014 to December 2015, were reviewed retrospectively. We compared between the high vs. the low lethality group, of which had been recorded based on clinical judgment using t-test or Chi2/Fisher's exact test with two-sided P-value of 0.05.ResultsAmong the 753 suicide attempters, the assessed lethality was recorded in 736 cases. Low and highly lethal attempters were 426 (57.9%) and 310 (42.1%), respectively. For demographic variables, the high lethality attempters were significantly more likely to be older (48.3 vs. 44.78; P = 0.009), unemployed (61.0% vs. 56.5%; P = 0.042, without religion (90.9% vs. 84.9%; P = 0.017). For clinical variables, the high lethality attempters were significantly more likely have hopelessness (67.7% vs. 58.2%; P = 0.013) and a history of schizophrenia (4.5% vs. 1.4%; P = 0.023, while they did display any difference for mood disorders. The low lethality suicide attempts were more frequent in patients with comorbid personality disorders (9.2% vs. 4.9%; P = 0.031).ConclusionsThese results are in line with literatures reporting higher suicide risk in people, who are old, unemployed, not having a religion, psychotic and hopeless. These may have been moderated by committing a higher lethal means of suicide at least in part and warrants additional investigations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Who gains from suicide risk assessment: Health inspectorate and health insurances, or also psychiatrist and patient?

2016 ◽  
Vol 33 (S1) ◽  
pp. S601-S601
Author(s):  
A. Gonlag ◽  
M. van Baest ◽  
C. Rijnders ◽  
R. Teijeiro
Keyword(s):  
Risk Assessment ◽  
The Netherlands ◽  
Suicidal Behaviour ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Suicide Risk Assessment ◽  
Treatment Policy ◽  
Observation Instruments ◽  
Competing Interest ◽  
Treatment Policies

IntroductionThe number of suicides rises in the Netherlands. In 2008, 1435 suicides were recorded; in 2012: 1753 (CBS). Adequate risk assessment with suicidal behaviour (SRA) is essential for prevention. The Health Inspectorate and Insurances seek to have a stronger grip on the way suicide risk is assessed and insist on using questionnaires. This runs counter to the multidisciplinary guidelines in the Netherlands for diagnosis and treatment of suicidal behaviour, which state that “questionnaires or observation instruments cannot replace clinical diagnostic examination.”ObjectiveDo questionnaires rather than ‘care as usual’ (CAU) in SRA lead to different treatment policies?AimTo determine whether the use of questionnaires rather than CAU in SRA leads to different treatment policies.MethodsPatients who were seen by staff at the department of Psychiatry at the ETS Hospital, either for in-house consultation or at the MPU, in connection with attempted suicide, auto-intoxication, or psychological distress with suicidal statements. Patients were examined by conducting a questionnaire, resulting in treatment policy (admission, discharge with an appointment with patient's own practitioner, discharge with referral to a practitioner, discharge without aftercare). Then, the same patient was again examined by another colleague in a free interview (CAU). The colleague was not informed about the outcome of the first assessment. Again, treatment policy was determined as a result. The two outcomes were then compared.ResultsData collection still continues.ConclusionsThere are signs that there are no differences in the determined treatment policies following SRA based on the use of questionnaires or CAU.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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