Lithium: poisonings and suicide prevention

SummaryThis study concerns 81 cases of lithium poisoning and shows that deliberate intoxications are prevalent during the first 3 years of lithium treatment as well as in cases with a previous history of suicide attempt. Therapeutic intoxications could generally be avoided by education concerning hygiene and diet and careful monitoring in cases of intercurrent diseases.

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Suicide attempts preceding completed suicide

The British Journal of Psychiatry ◽

10.1192/bjp.173.6.531 ◽

1998 ◽

Vol 173 (6) ◽

pp. 531-535 ◽

Cited By ~ 167

Author(s):

Erkki T. Isometsä ◽

Jouko K. Lönnqvist

Keyword(s):

Suicide Attempt ◽

Suicide Prevention ◽

Suicide Risk ◽

Suicide Attempts ◽

Early Recognition ◽

Preventive Measure ◽

Time Interval ◽

Psychological Autopsy ◽

Autopsy Study ◽

History Of

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.

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Precursors of compliance with lithium treatment in affective disorders

Psychiatric Bulletin ◽

10.1192/pb.25.5.183 ◽

2001 ◽

Vol 25 (5) ◽

pp. 183-186 ◽

Cited By ~ 4

Author(s):

Mairi S. Macleod ◽

Donald M. Sharp

Keyword(s):

Patient Satisfaction ◽

Affective Disorders ◽

Lithium Treatment ◽

Previous History ◽

Manic Depression ◽

Clinical Implications ◽

Knowledge And Attitudes ◽

History Of

Aims and MethodObjective and subjective lithium compliance was investigated in 30 out-patients attending at an affective disorders clinic. Possible precursors of compliance levels were investigated; namely lithium knowledge and attitudes, patient satisfaction and dosage of lithium administered.ResultsAll patients were defined as currently compliant. Patients with a previous history of non-compliance were exclusively diagnosed with manic depression. Patient satisfaction, lithium knowledge and attitudes were not good predictors of lithium compliance.Clinical ImplicationsCompliance with lithium can remain excellent in the presence of moderate lithium knowledge and poor attitudes. Poor attitude towards lithium worsens with years on medication, despite high levels of compliance. Clinicians should be aware that larger prescribed dosages of lithium may be associated with poorer compliance.

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Suicidality and associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorder: a cross-sectional study

10.21203/rs.3.rs-15831/v1 ◽

2020 ◽

Author(s):

Mayteewat Chiddaycha ◽

Peeraphon Lueboonthavatchai

Keyword(s):

Social Support ◽

Suicide Attempt ◽

Depressive Disorder ◽

Family Relationships ◽

Suicide Risk ◽

Previous History ◽

Clinical Factors ◽

Poor Family ◽

History Of ◽

Social Demographic

Abstract Background Some depressed people die by suicide although they are in treatment. The aims of this study were to examine the prevalence of suicidality and to identify the associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorders.Patients and methods A sample of 178 in- and outpatients with depressive disorders who were treated within the six-month period of being diagnosed or of a recurrent episode were recruited from a tertiary hospital during November 2017 to April 2018. The associations between suicide risks assessed using the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and various factors including demographic data, depressive severity, interpersonal problems, social support, family relationships, and life stress events were analyzed by chi-square test. Logistic regression was used for identification of the potential predictors of moderate-to-high suicide risk.Results Most of the subjects were single (80.9%), female (68%), and in early adulthood (mean age 28.9, SD 11.2). The prevalence of suicidal ideation, suicide attempt within one month, and previous history of suicide attempt during lifetime were 62.4%, 35.4% and 41%, respectively. The prevalence of suicidality (76.4%) and moderate-to-high suicide risk (48.4%) were high. The factors associated with moderate-to-high suicide risk were lower age, no religion, unemployment, history of substance use within one year, moderate-to-severe level of depression, being an in-patient, short duration of treatment, receiving benzodiazepines, having interpersonal role disputes, having interpersonal deficits, low social support, poor family relationships and functioning, and high severity level of health stress events. Potential predictors of moderate-to-high suicide risk were moderate-to-severe levels of depression, poor family relationships and functioning, age of 20 or lower, being an in-patient, and receiving benzodiazepines.Conclusion The prevalence of suicidality in patients with acutely treated depressive disorder was found to be high. Depressive severity and social factors such as poor family relationships were highly associated with suicide risk. Knowledge of these factors may raise awareness of suicide prevention during the course of treatment of depression.

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Drug Overdose-Induced Coma Blisters: Pathophysiology and Clinical and Forensic Diagnosis

Current Drug Research Reviews ◽

10.2174/1874473711666180730102343 ◽

2019 ◽

Vol 11 (1) ◽

pp. 21-25 ◽

Cited By ~ 1

Author(s):

Ricardo J. Dinis-Oliveira

Keyword(s):

Soft Tissue ◽

Suicide Attempt ◽

Drug Overdose ◽

State Of The Art ◽

Previous History ◽

Altered State ◽

Soft Tissue Involvement ◽

History Of ◽

Altered State Of Consciousness ◽

Limiting Condition

Background: Coma blisters or coma bullae are bullous lesions that have been associated with cases of drug overdose-induced coma. Previous history of suicide attempt by administering benzodiazepines, barbiturates, ethanol, antipsychotics, antidepressants or opioids have been particularly implicated. Patients may present also painful deep skin and soft tissue involvement, edema and functional impairment. The pathophysiology remains unknown and lesions are usually self-limited and typically resolve without scarring. Objective: This work aims to fully review the state of the art regarding the causes pathophysiology, diagnosis and treatment of drug overdose-induced coma blisters. Conclusion: Coma blisters are a benign, self-limiting condition that should be suspected in patients who develop pressure blisters several hours after an altered state of consciousness.

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A Comparison of Attitudes Toward Suicide Among Individuals With and Without Suicidal Thoughts and Suicide Attempts in South Korea

Crisis ◽

10.1027/0227-5910/a000528 ◽

2019 ◽

Vol 40 (1) ◽

pp. 27-35 ◽

Cited By ~ 2

Author(s):

Sang-Uk Lee ◽

Mina Jeon ◽

Jong-Ik Park

Keyword(s):

Suicide Attempt ◽

South Korea ◽

Suicide Prevention ◽

Suicide Attempts ◽

Suicidal Thought ◽

Suicidal Thoughts ◽

Cross Sectional ◽

Suicidal Person ◽

History Of ◽

Attitudes Toward Suicide

Abstract. Background: A suicidal person can go through different stages that include suicidal thoughts and suicide attempts. For a few individuals, these can end up with suicide. However, there have been no studies investigating any differences in attitudes toward suicides among individuals with no suicidal thoughts, those with suicidal thoughts, and those with suicide attempts. Aims: This study was carried out to compare attitudes toward suicide among three different groups: individuals with a history of no suicidal thoughts, those with a history of suicidal thoughts, and those with a history of suicide attempts. Method: To examine Koreans' attitudes toward suicide, we analyzed the data from the 2013 National Suicide Survey involving 1,500 participants aged between 19 and 75 years. Results: Different attitudes toward suicide were found among the three groups. Persons reporting that they had made a suicide attempt in their life showed the most permissive attitudes toward suicide. Limitations: Since this research is based on cross-sectional data, it is difficult to eliminate the possibility of changes in attitude toward suicide completely after having a suicidal thought and suicide attempt. Conclusion: These results can be a useful source for constructing effective messages for suicide prevention campaigns and can ultimately contribute to an improvement in the public's perceptions of suicide in the future.

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Ethical perspectives on suicide and suicide prevention

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.109.007021 ◽

2011 ◽

Vol 17 (3) ◽

pp. 214-219 ◽

Cited By ~ 2

Author(s):

Chris Kelly ◽

Eric Dale

Keyword(s):

Mental Illness ◽

Suicide Attempt ◽

Suicide Prevention ◽

Legal Practice ◽

Short Term ◽

Cry For Help ◽

History Of ◽

The Individual ◽

The Uk ◽

Ethical Perspectives

SummaryPhilosophy both influences and is influenced by clinical and legal practice relating to suicide. This article begins with a brief history of attitudes in the UK and Europe towards those who attempt suicide. It describes the main philosophical positions regarding suicide, including the principle of respect for life, the utilitarian position, the theological principle, and the principles of autonomy and duty to others. It concludes that short-term interventions are justified in most cases, for example when the suicide attempt is a ‘cry for help’ and/or the individual is ambivalent in their attempt or likely to have a mental illness.

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The Impact of Comorbidity on the Management of Pathological Gambling

CNS Spectrums ◽

10.1017/s109285290001957x ◽

2005 ◽

Vol 10 (8) ◽

pp. 619-621 ◽

Cited By ~ 7

Author(s):

Bernardo Dell'Osso ◽

Eric Hollander

Keyword(s):

Pathological Gambling ◽

Lithium Treatment ◽

Previous History ◽

Gambling Behavior ◽

Mood Stabilizers ◽

Obsessive Compulsive ◽

Psychotherapeutic Treatment ◽

Compulsive Disorder ◽

History Of ◽

The Impact

AbstractA 30-year-old woman with severe pathological gambling and cyclothymia presented to our program with no previous history of pharmacologic or psychotherapeutic treatment. Pathological gambling is an impulse-control disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) in which comorbidity is common, particularly with substance abuse, obsessive-compulsive disorder and mood disorders. As described in this case, pathological gamblers with bipolar comorbidity may be effectively treated with mood stabilizers such as lithium. After receiving 10 weeks of lithium treatment, the patient showed improvement in both gambling behavior and affective instability. The identification of specific subtypes among patients with pathological gambling may be relevant to the choice of pharmacologic treatment.

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