Facets of anger, childhood sexual victimization, and gender as predictors of suicide attempts by psychiatric patients after hospital discharge.

The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U.S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.

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Utilization of Emergency Departments for Psychiatric Treatment

Canadian Psychiatric Association Journal ◽

10.1177/070674377802300303 ◽

1978 ◽

Vol 23 (3) ◽

pp. 143-148 ◽

Cited By ~ 9

Author(s):

G.D. Watson

Keyword(s):

Emergency Department ◽

Emergency Services ◽

Suicide Attempts ◽

Psychiatric Treatment ◽

Psychiatric Patients ◽

Relevant Literature ◽

Emergency Department Utilization ◽

Annual Number ◽

Personal Distress ◽

Clinical Records

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.

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Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

Journal of Forensic Practice ◽

10.1108/jfp-12-2020-0053 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Vivienne de Vogel ◽

Nienke Verstegen

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Suicide Attempts ◽

Psychiatric Patients ◽

Forensic Mental Health ◽

Content Type ◽

Self Injury ◽

Forensic Psychiatric ◽

The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

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Late-life suicidal behaviours among new users of antidepressants: a prospective population-based study of sociodemographic and gender factors in those aged 75 and above

BMJ Open ◽

10.1136/bmjopen-2018-022703 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022703 ◽

Cited By ~ 2

Author(s):

Khedidja Hedna ◽

Karolina Andersson Sundell ◽

Gunnel Hensing ◽

Ingmar Skoog ◽

Sara Gustavsson ◽

...

Keyword(s):

Suicide Attempts ◽

Nordic Country ◽

Age Groups ◽

Antidepressant Medication ◽

Late Life ◽

Sociodemographic Factors ◽

Population Based ◽

Entire Cohort ◽

Hazard Ratios ◽

And Gender

ObjectiveTo investigate sociodemographic and gender factors associated with suicide and suicide attempts among new users of antidepressants aged 75 and above.DesignRegister-based cohort study.SettingNational population-based cohort of Swedish residents aged ≥75 years.Participants185 225 patients who initiated antidepressant medication between 1 January 2007 and 31 December 2013 were followed until 31 December 2014.Main outcome measuresSuicide and suicide attempts. Fine and Gray regression models were used to analyse the sociodemographic factors (age, country of birth, marital status, education level, last occupation, income and social allowance) associated with suicidal behaviours in the entire cohort and by gender.ResultsDuring follow-up, 295 suicides and 654 suicide attempts occurred. Adjusted sub-hazard ratios (aSHRs) for suicide were lower among older age groups (aSHR 0.73, 95% CI 0.53 to 0.99 for those 85–89 years; and aSHR 0.53, 95% CI 0.33 to 0.86 for those ≥90 years). A similar pattern was observed for suicide attempts. Suicide attempts were more common among those born in foreign countries (aSHR 1.58, 95% CI 1.16 to 2.15 for those born in another Nordic country; and aSHR 1.43, 95% CI 1.06 to 1.93 for those born in non-Nordic countries). In the gender-stratified analyses, being single or divorced, and born in another Nordic country was associated with a higher risk of suicide among men. Educational and occupational history and being born in a non-Nordic country influenced risk of suicidal behaviours in women.ConclusionSuicidal behaviours occurred more commonly among new users who were ‘younger’ old adults and those with foreign background, suggesting that those groups might require greater support when initiating antidepressant therapy. Our findings suggest the need for gender-specific, multifaceted approaches to the prevention of suicidal behaviours in late life.

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Risk of suicide after attempted suicide in the population of Slovenia from 1970 to 1996

European Psychiatry ◽

10.1016/j.eurpsy.2005.04.006 ◽

2006 ◽

Vol 21 (6) ◽

pp. 396-400 ◽

Cited By ~ 11

Author(s):

Slavko Ziherl ◽

Bojan Zalar

Keyword(s):

Suicide Attempt ◽

Attempted Suicide ◽

Suicide Attempts ◽

Categorical Variables ◽

Frequency Table ◽

Completed Suicide ◽

The Republic ◽

And Gender ◽

Log Linear ◽

Commit Suicide

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.

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Clinical Characteristics of Non-Suicidal Self-Injury and Suicide Attempts among Psychiatric Patients in Korea: A Retrospective Chart Review

Psychiatry Investigation ◽

10.30773/pi.2019.0269 ◽

2020 ◽

Vol 17 (4) ◽

pp. 320-330

Author(s):

Yubeen Bae ◽

Yoanna Seong ◽

Seok Hyeon Kim ◽

Sojung Kim

Keyword(s):

Clinical Characteristics ◽

Chart Review ◽

Suicide Attempts ◽

Medical Center ◽

Psychiatric Patients ◽

Retrospective Chart Review ◽

The Other ◽

Novelty Seeking ◽

Medical Chart Review ◽

Self Injury

Objective Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study, we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts.Methods We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric department of a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of three groups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristics and psychological assessments.Results Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likely to be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorder than the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8, RC9 in MMPI-2.Conclusion Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychological disturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.

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Oral lesions in patients with psychiatric disorders

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1010564j ◽

2010 ◽

Vol 138 (9-10) ◽

pp. 564-569 ◽

Cited By ~ 5

Author(s):

Svetlana Jovanovic ◽

Ivanka Gajic ◽

Bojan Mandic ◽

Jelena Mandic ◽

Vlada Radivojevic

Keyword(s):

Psychiatric Disorders ◽

Facial Pain ◽

Psychiatric Patients ◽

Medical Documentation ◽

Oral Lesions ◽

Age And Gender ◽

Taste Changes ◽

Swallowing Difficulties ◽

And Gender ◽

Healthy Persons

Introduction. Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. Objective. The aim of this study was to detect oral lesions in patients hospitalized in psychiatric institutions with the confirmed diagnosis of psychiatric illness and mood disorder with psychotic characteristics, as well as to discover the factors that can influence these oral lesions. Methods. Cross-section study consisted of 186 hospitalized patients with psychiatric disorders in the experimental group, out of whom 87 were males and 99 females. Patients were aged from 18 to 59 years, mean age 46.0?8.0 years. The control group consisted of 186 healthy persons matched for age and gender. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by Student?s t-test, chi-square test and logistic regression. Results. Dry mouth was registered in 78.5% of patients. The difference in tongue and lip lesions, burning and stinging symptoms, bruxism, facial pain, low saliva rates, halitosis, taste changes and swallowing difficulties between the patients and healthy persons was highly statistically significant (p<0.001). Age and gender, as well as the factors of main disease, influence burning and stinging, bruxism, low saliva rates, swallowing difficulties, taste changes and facial pain of the psychiatric patients. Conclusion. Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, as well as with doctors who treat the basic illness.

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Influences on fit between psychiatric patients' psychosocial needs and their hospital discharge plan

Psychiatric Services ◽

10.1176/ps.48.4.518 ◽

1997 ◽

Vol 48 (4) ◽

pp. 518-523 ◽

Cited By ~ 7

Keyword(s):

Hospital Discharge ◽

Psychiatric Patients ◽

Psychosocial Needs ◽

Discharge Plan

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Institutional Response and Impact of Reporting Sexual Violence: An Examination of Sexual and Gender Minority College Students

Journal of Interpersonal Violence ◽

10.1177/08862605211055078 ◽

2021 ◽

pp. 088626052110550

Author(s):

Lauren R. Grocott ◽

Nykia R. Leach ◽

Leslie A. Brick ◽

Richard Meza-Lopez ◽

Lindsay M. Orchowski

Keyword(s):

College Students ◽

Sexual Violence ◽

Minority Students ◽

Sexual Minority ◽

Sexual Victimization ◽

Poor Response ◽

College Campuses ◽

Institutional Response ◽

Heterosexual Women ◽

And Gender

Although college students who are sexual and gender minorities (SGM) experience higher rates of sexual victimization than their peers who identify as heterosexual and cisgender, there is a paucity in the literature investigating how college campuses can address the needs of SGM college students in violence prevention and response. The present research examines a subset of data from the Healthy Minds Survey (HMS), a national web-based survey administered across two universities from 2016 to 2017. We examined the role of SGM status in the rates of sexual violence, perceptions of their college/university’s institutional response to reports of sexual violence (e.g., taking a report seriously and taking corrective action), and the perceived impact of reporting sexual violence (e.g., students would support the person making a report). Logistic regression analyses revealed higher rates of sexual victimization among sexual minority students (compared to heterosexual), women (compared to men), and transgender and gender diverse (TGD) students (compared to cisgender). In addition, sexual minority (compared to heterosexual), women (compared to men), and TGD (compared to cisgender) students were more likely to perceive their institution would have a poor response to reports of sexual violence. Women and sexual minority students were also likely to believe that students who report sexual violence would suffer academically. These findings highlight the need for continued efforts to enhance sexual assault prevention and response efforts on college campuses, especially for SGM students.

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Outpatient Psychotropic Drug Interactions in a Public Psychiatry Hospital in Bahrain: An Audit Study

Current Psychopharmacologye ◽

10.2174/2211556010666210701164436 ◽

2021 ◽

Vol 10 ◽

Author(s):

Yasin Tayem ◽

Saeed Aljaberi ◽

Ali Alfehaid ◽

Abdulaziz Almekhyal ◽

Haitham Jahrami ◽

...

Keyword(s):

Drug Interactions ◽

Psychotropic Drugs ◽

Psychiatric Patients ◽

Psychotropic Medications ◽

Outpatient Psychiatry ◽

High Prevalence ◽

Public Psychiatry ◽

And Gender ◽

Potential Interactions ◽

Outpatient Prescriptions

Background: Psychotropic polypharmacy is particularly common which puts psychiatric patients at high risk for developing drug-drug interactions. Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting. Method: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the degree and correlation between psychotropic drugs. Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001), and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05). Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

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