scholarly journals Suicidal patients in a psychiatric emergency unit: clinical characteristics and aggression profile

2019 ◽  
Vol 41 (1) ◽  
pp. 9-17
Author(s):  
Vítor Crestani Calegaro ◽  
Cleonice Zatti ◽  
Andre Goettems Bastos ◽  
Lucia Helena Machado Freitas
Keyword(s):  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Psychiatric Emergency ◽  
Future Research ◽  
Recent Attempt ◽  
Prior History ◽  
History Of ◽  
Psychiatric Rating Scale ◽  
Suicidal Patients

Abstract Objective To explore and describe a profile of patients admitted to a psychiatric emergency facility, comparing patients with and without a recent suicide attempt in terms of their clinical characteristics and aggression. Methods This was an exploratory comparative study where patients were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Scale (OAS). Participants with a suicide attempt in the last 24 hours (SA) were compared to participants with a prior history of suicide attempt but no recent attempt (PHSA). Results 63 individuals (SA: 26; PHSA: 37) were selected. Both groups had similar demographic and clinical characteristics. The most prevalent diagnoses were mood (57.1%) and personality (50.8%) disorders. The majority of patients in both groups had a history of aggression episodes. Physical aggression in the week prior to admission was more prevalent in the PHSA group (51.4 vs. 19.2%, p = 0.017). The PHSA group also presented higher activation scores (p = 0.025), while the SA group presented higher affect scores on BPRS dimensions (p = 0.002). Conclusion The majority of individuals with a history of suicide attempt also presented a history of aggression. Inpatients with recent suicide attempt were hospitalized mainly due to the risk of suicide, while those with no recent suicide attempt were hospitalized mainly due to the risk of hetero-aggression. These findings support the hypothesis of an aggressive profile in suicidal patients and may open up a path for future research.

Suicide attempters: Clinical characteristics and management

2016 ◽  
Vol 33 (S1) ◽  
pp. S601-S601
Author(s):  
E. Gattoni ◽  
A. Feggi ◽  
C. Gramaglia ◽  
P. Bergamasco ◽  
I. Coppola ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Suicide Attempt ◽  
Clinical Characteristics ◽  
Depressive Disorders ◽  
Attempted Suicide ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Suicidal Risk ◽  
Suicide Attempters ◽  
History Of

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Some Familial and Clinical Characteristics of Female Suicidal Psychiatric Patients

1981 ◽  
Vol 138 (5) ◽  
pp. 381-390 ◽  
Author(s):  
John Birtchnell
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behaviour ◽  
Clinical Characteristics ◽  
Psychiatric Patients ◽  
Poor Quality ◽  
History Of ◽  
Severity Of Depression ◽  
To Come ◽  
Suicidal Patients

SummaryThe study compares 72 female psychiatric patients who had a history of suicide attempt with 122 who had neither attempted nor contemplated suicide. Of these 194 women, 128 had experienced the death of their mothers before the age of 11, but the proportions of early bereaved and not early bereaved who were suicidal were similar. Not even the events which followed bereavement affected suicidal behaviour, but the suicidal patients tended to come from larger sibships. Poor quality of the marriage and, for the early bereaved only, having three or more children related significantly to suicidal behaviour. The suicidal women were significantly more often described as dependent. Suicidal behaviour was not differentiated on the endogenous/neurotic depressive dichotomy but it was significantly related to severity of depression.

Factors associated with foreign language anxiety

1999 ◽  
Vol 20 (2) ◽  
pp. 217-239 ◽  
Author(s):  
ANTHONY J. ONWUEGBUZIE ◽  
PHILLIP BAILEY ◽  
CHRISTINE E. DALEY
Keyword(s):  
Foreign Language ◽  
Language Learning ◽  
Foreign Language Learning ◽  
Language Anxiety ◽  
Foreign Language Anxiety ◽  
Future Research ◽  
Prior History ◽  
Foreign Countries ◽  
Self Worth ◽  
History Of

Foreign language anxiety is a complex phenomenon that has been found to be a predictor of foreign language achievement. This study of 210 university students examined factors that predict1 foreign language anxiety. A setwise multiple regression analysis revealed that seven variables (i.e., age, academic achievement, prior history of visiting foreign countries, prior high school experience with foreign languages, expected overall average for current language course, perceived scholastic competence, and perceived self-worth) contributed significantly to the prediction of foreign language anxiety. An analysis of variance, which included trend analysis, revealed that freshmen and sophomores reported the lowest levels of foreign language anxiety, and that anxiety levels increased linearly as a function of year of study. The educational implications of these findings for understanding foreign language anxiety and for increasing foreign language learning are discussed, as are suggestions for future research.

Suicidal Plans in Patients With Stroke: Comparison Between Acute-Onset and Delayed-Onset Suicidal Plans

1996 ◽  
Vol 8 (4) ◽  
pp. 623-634 ◽  
Author(s):  
Yasuhiro Kishi ◽  
Robert G. Robinson ◽  
James T. Kosier
Keyword(s):  
Alcohol Abuse ◽  
Depressive Disorders ◽  
Acute Onset ◽  
Prior History ◽  
Psychological Mechanisms ◽  
Delayed Onset ◽  
History Of ◽  
Suicidal Patients ◽  
Suicidal Plans

Three hundred one patients were examined for suicidal plans during the acute hospital period following stroke and at 3, 6, 12, and 24 months' follow-up. It was found that 6.6% of patients developed suicidal plans during the initial in-hospital evaluation (acute-onset suicidal plans) and 11.3% of patients developed suicidal plans at 3, 6, 12, or 24 months' follow-up (delayed-onset suicidal plans). The development of both acute and delayed-onset suicidal plans was strongly related to the existence of depressive disorders, especially major depression, and to a prior history of stroke. Acute-onset suicidal plans were also related to premorbid alcohol abuse. Acute-onset suicidal patients had more anterior lesion location and delayed-onset suicidal patients had more posterior stroke lesions. Delayed-onset suicidal plans were not related to alcohol abuse but tended to be associated with greater physical impairment and poorer social support during the acute poststroke period. These data suggest that the etiology of these two types of suicidal plans may be different with acute onset related to biological mechanisms and delayed onset related to psychological mechanisms.

Differences between female suicidal patients with family history of suicide attempt and family history of completed suicide

2016 ◽  
Vol 70 ◽  
pp. 25-31 ◽  
Author(s):  
D. Rodante ◽  
S.M. Rojas ◽  
M.T. Feldner ◽  
C. Dutton ◽  
F. Rebok ◽  
...  
Keyword(s):  
Family History ◽  
Suicide Attempt ◽  
Completed Suicide ◽  
History Of ◽  
Suicidal Patients

Decision Making about Dangerousness in Releasing Patients from Long-term Psychiatric Hospitalization

1992 ◽  
Vol 20 (1) ◽  
pp. 35-47 ◽  
Author(s):  
Paul D. Werner ◽  
J. Reid Meloy
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Rating Scale ◽  
Psychiatric Hospitalization ◽  
Health Workers ◽  
Mental Health Workers ◽  
Future Research ◽  
Outpatient Program ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

This study examined mental health practitioners’ approaches to judging psychiatric inpatients’ dangerousness at the time of decision making about hospital discharge. Brief Psychiatric Rating Scale (BPRS) descriptions of 50 inpatients were studied in relation to four assessors’ evaluations of patients’ dangerousness and their recommendations regarding conditional release to an outpatient program. Judged dangerousness was well modeled by a multiple linear regression equation (R = .91) and was found positively correlated with 13 BPRS variables. Five BPRS scales associated with the recommendation to discharge patients were also identified. On two-year followup none of the patients released to the outpatient program was found to have committed a violent act. Results were compared with prior findings on mental health workers’ decision making about violence, and recommendations for future research were discussed.

scholarly journals Clozapine Treatment in Patients with Prior Substance Abuse

2003 ◽  
Vol 48 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Deanna L Kelly ◽  
Elizabeth A Gale ◽  
Robert R Conley
Keyword(s):  
Substance Abuse ◽  
Rating Scale ◽  
Therapeutic Option ◽  
Research Unit ◽  
Treatment Resistant ◽  
Clozapine Treatment ◽  
History Of ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale ◽  
One Year

Objective: This study examined outcomes following discharge on clozapine for treatment-resistant schizophrenia patients with and without diagnosed substance abuse histories. Methods: Those discharged on clozapine from a research unit between April 1991 and March 1996 were followed with respect to hospitalization status. Of the treatment-resistant patients with schizophrenia, 19 were diagnosed as individuals with substance abuse, while 26 patients had no history of abuse. Patients were openly treated with clozapine and were included in the study if they were stabilized and discharged on the medication. Results: Patients who had histories of abuse exhibited a better treatment response and a lower total Brief Psychiatric Rating Scale (BPRS) score at discharge, compared with the non–substance abuse group. One-year readmission rates were 21% and 23% in patients with and without prior substance abuse histories, respectively ( P = ns). Conclusions: Clozapine may be a therapeutic option for the dually diagnosed population and may offer benefits to patients with schizophrenia who have a history of substance abuse.

scholarly journals MATERNAL GRAVES DISEASE AND ABNORMAL CYP2D6 GENOTYPE WITH FETAL HYPERTHYROIDISM

2020 ◽  
Vol 6 (4) ◽  
pp. e161-e164
Author(s):  
Christopher Spoke ◽  
Christopher Martin
Keyword(s):  
Cytochrome P450 ◽  
Antithyroid Drug ◽  
Future Research ◽  
Prior History ◽  
Graves Disease ◽  
Cyp2d6 Genotype ◽  
Fetal Ultrasound ◽  
Cyp2d6 Polymorphism ◽  
Imaging Results ◽  
History Of

Objective: Fetal hyperthyroidism is a rare yet potentially fatal complication of past or present maternal Graves disease (GD). Our objective was to present a unique case of fetal hyperthyroidism in a mother with a prior history of GD and a cytochrome P450 2D6 (CYP2D6) polymorphism. Methods: The clinical course in addition to serial laboratory and imaging results are presented. These include thyroid-stimulating hormone, free thyroxine, and thyrotropin receptor antibody levels, as well as fetal ultrasound, doppler fetal heart rate, and cordocentesis testing. Results: A 27-year-old with a history of GD previously treated with radioiodine and a known cytochrome P450 polymorphism was referred to an endocrinology clinic at 17 weeks gestation for evaluation and management of fetal thyrotoxicosis. Despite close follow-up with a multidisciplinary care team and an aggressive “block and replace” treatment approach, progressive disease resulted in intrauterine fetal demise at 28 weeks gestation. Conclusion: To our knowledge, this is the first published case report of fetal hyperthyroidism accompanied by a maternal CYP2D6 polymorphism. We hypothesize that the maternal CYP2D6 poor metabolizer phenotype prevents formation of antithyroid drug (ATD) metabolites and thus decreases the efficacy of ATD treatment. We suggest this as an area of future research.

Checking the Math: Do Restrictive Housing and Mental Health Need Add Up to Psychological Deterioration?

2018 ◽  
Vol 45 (9) ◽  
pp. 1347-1362 ◽  
Author(s):  
Glenn D. Walters
Keyword(s):  
Mental Health ◽  
Rating Scale ◽  
Growth Mixture Modeling ◽  
Psychological Status ◽  
Psychological Reactions ◽  
Administrative Segregation ◽  
Growth Mixture ◽  
History Of ◽  
Psychiatric Rating Scale ◽  
Health Need

The current study sought to determine whether restrictive housing leads to psychological deterioration. A growth mixture modeling analysis of clinician ratings on the Brief Psychiatric Rating Scale identified two classes of participants in a sample of 266 state prison inmates: A large group of prisoners whose psychological status gradually improved over the course of a year and a small group of inmates whose psychological status deteriorated over the course of a year. Inmates with a history of mental health need were significantly more likely to experience severe psychological reactions to administrative segregation (AS) than inmates with no history of mental health need, although inmates with a history of mental health need were just as likely to experience severe psychological deterioration in general population as in AS. These results indicate that psychological deterioration in mentally ill inmates may have less to do with AS than with incarceration in general.

Beliefs about antidepressants among persons aged 70 years and older in treatment after a suicide attempt

2015 ◽  
Vol 27 (11) ◽  
pp. 1795-1803 ◽  
Author(s):  
Eva Lesén ◽  
Stefan Wiktorsson ◽  
Anders Carlsten ◽  
Margda Waern ◽  
Tove Hedenrud
Keyword(s):  
Suicide Attempt ◽  
Suicide Risk ◽  
Older Persons ◽  
Medication Use ◽  
Objective Measures ◽  
Psychiatric Evaluation ◽  
Prior History ◽  
History Of ◽  
One Year

ABSTRACTBackground:The use of antidepressants is associated with decreased suicide risk in late life, and these drugs are often prescribed after a suicide attempt. Yet little is known about attitudes to antidepressants in older persons with suicidal behavior. The aim of this study was to assess beliefs about antidepressant medicines in older persons in treatment one year after a suicide attempt.Methods:Forty-four individuals aged 70 years and older, who were treated in emergency wards at five hospitals in western Sweden in connection with a suicide attempt, were interviewed at index attempt and one year later. Beliefs about medicines questionnaire (BMQ) specific for antidepressants were analyzed one year after index attempt, in relation to sociodemographic variables, medication use, psychiatric evaluation, and personality traits.Results:The majority of participants perceived the necessity of their antidepressant medicine to outweigh their concerns. Lower perceived necessity of antidepressants was observed in those who were not on antidepressants at the time of the attempt as well as those with no prior history of suicide attempt before the index attempt. Individuals reporting hopelessness at follow-up had a higher perceived concern about using medication.Conclusions:Beliefs about antidepressants tended to be more positive than negative in older persons taking these drugs in the aftermath of a suicide attempt. Further studies are called for, and should include objective measures of medication adherence.

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