Reassessment of Suicide Attempters at Home, Shortly After Discharge from Hospital

Crisis ◽  
2010 ◽  
Vol 31 (6) ◽  
pp. 303-310 ◽  
Author(s):  
Bas Verwey ◽  
Jeroen A. van Waarde ◽  
Molla A. Bozdağ ◽  
Iris van Rooij ◽  
Edwin de Beurs ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
General Hospital ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Suicide Attempters ◽  
Systematic Assessment ◽  
Suicide Intent ◽  
Initial Hospital ◽  
Discharge From Hospital ◽  
At Home

Background: Assessment of suicide attempters in a general hospital may be influenced by the condition of the patient and the unfavorable circumstances of the hospital environment. Aims: To determine whether the results of a reassessment at home shortly after discharge from hospital differ from the initial assessment in the hospital. Methods: In this prospective study, systematic assessment of 52 suicide attempters in a general hospital was compared with reassessment at home, shortly after discharge. Results: Reassessments at home concerning suicide intent, motives for suicide attempt, and dimensions of psychopathology did not differ significantly from the initial hospital assessment. However, patients’ motives for the suicide attempt had changed to being less impulsive and more suicidal, worrying was significantly higher, and self-esteem was significantly lower. A third of the patients had forgotten their aftercare arrangements and most patients who initially felt no need for additional help had changed their mind at reassessment. Conclusions: Results from this group of suicide attempters suggest that a brief reassessment at home shortly after discharge from hospital should be considered.

Challenges in Assessing Intent to Die: Can Suicide Attempters Be Trusted?

2007 ◽  
Vol 55 (1) ◽  
pp. 57-70 ◽  
Author(s):  
Stacey Freedenthal
Keyword(s):  
Risk Assessment ◽  
Suicide Attempt ◽  
Circumstantial Evidence ◽  
Accurate Assessment ◽  
Secondary Gain ◽  
Suicide Attempters ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicide Note

Assessing a person's intent to die in a suicide attempt is crucial for risk assessment and research, yet suicidal intent is notoriously difficult to measure. People who intended to die when they hurt themselves may deny it, and others may feign intent for secondary gain. Additionally, ambivalence, memory gaps, impulsivity, and fluidity of intent can hinder accurate assessment of intent. Circumstantial evidence, such as a suicide note, may illuminate true intentions but also has substantial limitations. This article summarizes disparate challenges to the measurement of suicidal intent; describes strengths and weaknesses of circumstantial indicators; reviews evidence from studies using the Suicide Intent Scale to show that subjective and circumstantial indicators do not strongly correlate with each other; and concludes with a call to place more trust in individuals whose disclosures of suicidal intent are questionable, even if the possibility for manipulation exists.

scholarly journals Home to Stay: An Integrated Monitoring System Using a Mobile App to Support Patients at Home Following Colorectal Surgery

2020 ◽  
Vol 7 (6) ◽  
pp. 1241-1246
Author(s):  
Christine J S Keng ◽  
Alifiya Goriawala ◽  
Saira Rashid ◽  
Rachel Goldstein ◽  
Selina Schmocker ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Monitoring System ◽  
Readmission Rate ◽  
Mobile App ◽  
Initial Assessment ◽  
Quality Of Recovery ◽  
Discharge Monitoring ◽  
Discharge From Hospital ◽  
At Home

Background: Patients undergoing colorectal surgery are vulnerable during their transition from hospital to home and require increased support following discharge from hospital. Study objectives were to perform an initial assessment of patient uptake, outcomes, and satisfaction with an integrated discharge monitoring system called Home to Stay. Methods: The intervention was an integrated discharge monitoring system that uses a mobile app platform. Patients downloaded the app prior to discharge from hospital and received a Daily Health Check day #1 to #14, #21, and #30. Patient responses’ were accessed by the health-care team via secure web site, and extreme responses were “flagged” to indicate that a follow-up telephone call was necessary. Primary outcomes were patient uptake, Quality of Recovery scores and satisfaction with the program. Secondary outcomes were 30-day emergency room (ER) visits and readmissions. Results: One hundred and thirty-two patients were invited to participate and 106 accepted. Of these, 93 used the app at least once. The mean overall score on the Quality of Recovery Scale increased significantly from day 1 to day 14. Patient satisfaction with the app was high, with 92% of patients reporting overall satisfaction as good or excellent. The 30-day readmission rate was 6% and was lower than the 30-day readmission rate of 18% reported for the 4 months prior to the start of the study. Conclusions: The Home to Stay Program to support patients at home after colorectal surgery is feasible with high patient uptake and satisfaction. This program has the potential to reduce 30-day readmissions, however further studies are required.

Characteristics of Suicidal Behavior in a Turkish Sample

Crisis ◽  
2009 ◽  
Vol 30 (2) ◽  
pp. 90-93 ◽  
Author(s):  
Osman Ozdel ◽  
Gulfizar Varma ◽  
Figen C. Atesci ◽  
Nalan K. Oguzhanoglu ◽  
Filiz Karadag ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Clinical Characteristics ◽  
Religious Orientation ◽  
Educational Status ◽  
Suicide Attempters ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
The Family ◽  
Dsm Iv

Background: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. Aims: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. Methods: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck’s Hopelessness Scale (BHS), Becks’s Suicidal Ideation Scale (SIS), and Beck’s Suicidal Intention Scale (BSIS) were collected. Results: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most fre uent psychological stress factor. Three- uarters of attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder. Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. Conclusions: In the present study, the findings are useful in showing the risk factors related to suicidal behavior.

Factor Structure of Beck's Suicide Intent Scales

1977 ◽  
Vol 40 (1) ◽  
pp. 295-302 ◽  
Author(s):  
Richard D. Wetzel
Keyword(s):  
Suicide Attempt ◽  
Factor Structure ◽  
General Factor ◽  
Factor Scores ◽  
Suicide Attempters ◽  
Suicidal Intent ◽  
Suicide Intent

Data obtained from 48 suicide attempters and 56 suicide threateners on three of Beck's suicide intent scales were factor analyzed. The scale, attempt suicide intent, yielded four orthogonal factors reflecting seriousness of intent, lethality of the act, precautions against interference and failure to initiate rescue after the attempt. The current scale of suicidal intent yielded four factors, bur one, the still suicidal factor, accounted for 44% of the variance. The suicide ideators scale yielded a general factor, called specificity of planning, accounting for more than half the variation. Factor scores were computed and correlated with diagnostic groupings. Character disordered subjects were more likely to report both more serious intent at time of suicide attempt and at interview than other attempters.

Depressed Multiple-Suicide­Attempters – A High-Risk Phenotype

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 367-375 ◽  
Author(s):  
Leo Sher ◽  
Michael F. Grunebaum ◽  
Ainsley K. Burke ◽  
Sadia Chaudhury ◽  
J. John Mann ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Depressed Patients ◽  
Suicide Intent ◽  
History Of ◽  
Cross Sectional Design

Abstract. Background: There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts. Aim: This study aimed to examine psychopathology in multiple-suicide attempters. Method: We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters). Results: We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters. Limitations: The cross-sectional design of the study. Conclusion: Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

The rise and fall of PET and PET/CT

2005 ◽  
Vol 44 (S 01) ◽  
pp. S58-S60 ◽  
Author(s):  
W. Mohnike
Keyword(s):  
Clinical Practice ◽  
General Hospital ◽  
Private Practice ◽  
Ct Imaging ◽  
Hospital Environment ◽  
Governmental Organizations ◽  
Pet Ct

Summary:PET is being considered a diagnostic commodity in clinical practice worldwide and thus receives increasing attention by health insurances and governmental organizations. In Germany, however, neither PET nor PET/CT are subject to reimbursement. This renders clinical PET and PET/CT imaging a challenge both in a general hospital environment and in private practice. This article describes briefly these challenges, which are not solely related to turf battles and associated costs.

Description of multimorbidity clusters of admitted patients in medical departments of a general hospital

2021 ◽  
pp. postgradmedj-2020-139361
Author(s):  
María Matesanz-Fernández ◽  
Teresa Seoane-Pillado ◽  
Iria Iñiguez-Vázquez ◽  
Roi Suárez-Gil ◽  
Sonia Pértega-Díaz ◽  
...  
Keyword(s):  
General Hospital ◽  
Multiple Correspondence Analysis ◽  
Hypertensive Heart Disease ◽  
Chronic Kidney Failure ◽  
Hospital Environment ◽  
Heart Valve Disease ◽  
Malignant Neoplasms ◽  
Hospital Data ◽  
Data Set ◽  
And Gender

ObjectiveWe aim to identify patterns of disease clusters among inpatients of a general hospital and to describe the characteristics and evolution of each group.MethodsWe used two data sets from the CMBD (Conjunto mínimo básico de datos - Minimum Basic Hospital Data Set (MBDS)) of the Lucus Augusti Hospital (Spain), hospitalisations and patients, realising a retrospective cohort study among the 74 220 patients discharged from the Medic Area between 01 January 2000 and 31 December 2015. We created multimorbidity clusters using multiple correspondence analysis.ResultsWe identified five clusters for both gender and age. Cluster 1: alcoholic liver disease, alcoholic dependency syndrome, lung and digestive tract malignant neoplasms (age under 50 years). Cluster 2: large intestine, prostate, breast and other malignant neoplasms, lymphoma and myeloma (age over 70, mostly males). Cluster 3: malnutrition, Parkinson disease and other mobility disorders, dementia and other mental health conditions (age over 80 years and mostly women). Cluster 4: atrial fibrillation/flutter, cardiac failure, chronic kidney failure and heart valve disease (age between 70–80 and mostly women). Cluster 5: hypertension/hypertensive heart disease, type 2 diabetes mellitus, ischaemic cardiomyopathy, dyslipidaemia, obesity and sleep apnea, including mostly men (age range 60–80). We assessed significant differences among the clusters when gender, age, number of chronic pathologies, number of rehospitalisations and mortality during the hospitalisation were assessed (p<0001 in all cases).ConclusionsWe identify for the first time in a hospital environment five clusters of disease combinations among the inpatients. These clusters contain several high-incidence diseases related to both age and gender that express their own evolution and clinical characteristics over time.

scholarly journals Chromosome 22 Deletions and Suicidal Behavior in Schizophrenia

2021 ◽  
pp. 1-8
Author(s):  
Ali Bani-Fatemi ◽  
Christopher Adanty ◽  
Nasia Dai ◽  
Ariel Graff ◽  
Philip Gerretsen ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Copy Number ◽  
Rating Scale ◽  
Copy Number Variant ◽  
Chromosome 22 ◽  
Suicide Attempters ◽  
Severity Rating ◽  
Neuropsychiatric Diseases ◽  
Significant Difference

Background: Studies have shown that the overall copy number variant (CNV) load is associated with schizophrenia. Schizophrenia is a mental disorder that is frequently associated with suicidal behavior. Methods: We recruited 263 patients with schizophrenia from the Centre for Addiction and Mental Health. The Columbia Suicide Severity Rating Scale was used to assess the presence of lifetime suicide attempt. Genotyping was completed using the Illumina Omni 2.5 chip. We tested the association between deletion events on chromosome 22 with suicide attempt in our schizophrenia sample. Results: There was no significant difference between suicide attempters and non-attempters considering the presence/absence of deletion events on chromosome 22. Conclusion: Although our results did not show a significant association between deletions on chromosome 22 and suicide attempt in schizophrenia, CNV studies may reveal important, novel insights and open further investigation for the treatment of neuropsychiatric diseases.

scholarly journals A study of preoperative, intra-operative and postoperative factors responsible for postoperative wound infection

2017 ◽  
Vol 4 (5) ◽  
pp. 1569
Author(s):  
Shobha S. Nisale ◽  
Meghraj Chawada ◽  
Ganesh K. Kharkate ◽  
Sudhir B. Deshmukh
Keyword(s):  
Wound Infection ◽  
Care Center ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Postoperative Wound Infection ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Health Care Center ◽  
Duration Of Surgery ◽  
Operative Findings

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

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