scholarly journals Suicide Risk in Schizophrenia, a 20 Year Cohort Study, Part 1: Outcome and associated social factors

2009 ◽  
Vol 15 (3) ◽  
pp. 6
Author(s):  
G Lippi ◽  
D J Smit ◽  
J C Jordaan ◽  
J L Roos
Keyword(s):  
Adverse Effects ◽  
Social Factors ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Current Knowledge ◽  
Social Withdrawal ◽  
Depression Scale ◽  
Original Study ◽  
Psychological Autopsy ◽  
Formal Thought Disorder

<p><strong>Objective:</strong> This study prospectively followed up, after a period of 20 years, a group of patients with schizophrenia who were considered to be at high risk for suicide. In Part 1, we reported on outcome and associated social factors, and in this paper we discuss re-evaluated suicide risk in these patients and investigated symptomology and pharmacotherapy over the last 2 decades.</p><p><strong> Method:</strong> The subjects were interviewed, and a questionnaire evaluating suicide risk was completed. The Beck Hopelessness Scale (BHS) was administered and ratings were compared to those from the original study. The Calgary Depression Scale for Schizophrenia (CDSS) was also administered. Cross tabulations were then performed to identify factors associated with increased suicide risk. For those subjects who committed suicide since the original study, a psychological autopsy was performed.</p><p><strong>Results:</strong> Fourteen of the original 33 high suicide risk schizophrenia patients were found. Three subjects committed suicide during the 20 year period. Among the living subjects, risks for suicide were found to be lower than 20 years ago. Hopelessness and depressive symptoms correlated with independently evaluated suicide risk. Social withdrawal, blunting of affect and delusions were also associated with elevated risk. Good insight into illness and a history of previous suicide attempts correlate with high suicide risk. Cannabis abuse, poor or periodic adherence to treatment, as well as weight gain, akathisia and parkinsonian adverse effects were also associated with an increase in risk for suicide. Formal thought disorder, avolition and cognitive impairment were associated with lower risk of suicide.</p><p><strong>Conclusion:</strong> Hopelessness, depression, certain positive symptoms and adverse effects of medication, found in this study to be congruent with suicide risk in patients with schizophrenia, coincide with those mentioned in the literature. Despite current knowledge about this subject, suicide remains notoriously and ominously unpredictable in patients with schizophrenia.</p>

scholarly journals Suicide Risk in Schizophrenia - a follow-up study after 20 years. Part 2: Symptomatology and pharmacotherapy

2009 ◽  
Vol 15 (4) ◽  
pp. 7
Author(s):  
G Lippi ◽  
D J Smit ◽  
J C Jordaan ◽  
J L Roos
Keyword(s):  
Suicide Risk ◽  
Depression Scale ◽  
Original Study ◽  
Psychological Autopsy ◽  
Illness Onset ◽  
Face To Face ◽  
Factors Associated ◽  
Poor Social Support ◽  
Discharge From Hospital

<p><strong>Objective: </strong> This study prospectively re-evaluated, after a period of 20 years, a cohort of patients with schizophrenia who had been considered to be at high risk for suicide. The outcome and social factors associated with their suicide risk were investigated over the 2 decades. Method Subjects were contacted and interviewed face-to-face by following a questionnaire devised for this purpose. The Beck Hopelessness Scale (BHS) was administered and ratings were compared to those from the original study. The Calgary Depression Scale for Schizophrenia (CDSS) was administered. Cross tabulations were performed to identify factors associated with increased suicide risk. A psychological autopsy was performed, for those subjects who had committed suicide since the original study.</p><p><strong>Results:</strong>Fourteen of the original 33 high suicide risk schizophrenia patients were found. Three subjects committed suicide during the 20 year period. Among the living subjects, risks for suicide were found to be lower than 20 years ago. Male gender, poor social support, early age of illness onset, current admission to or recent discharge from hospital and a higher level of education were all factors associated with increased suicide risk. <strong></strong></p><p><strong>Conclusion:</strong> Demographic factors and those related to illness course, found in this study to be associated with suicide risk in patients with schizophrenia, are congruous with those mentioned in the literature.</p>

Suicide attempts preceding completed suicide

1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
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.

Electrodermal Reactivity and Suicide

2017 ◽  
Vol 41 (S1) ◽  
pp. S49-S49
Author(s):  
M. Sarchiapone
Keyword(s):  
Suicide Risk ◽  
Suicide Attempts ◽  
Depressive Symptomatology ◽  
Electrodermal Activity ◽  
Electrical Conductance ◽  
Depression Scale ◽  
High Sensitivity ◽  
Primary Diagnosis ◽  
Suicide Intent ◽  
High Negative Predictive Value

Electrodermal Activity (EDA) refers to changes in electrical conductance of the skin. Electrodermal hyporeactive individuals are those who show an unusual rapid habituation to identical non-significant stimuli. Previous findings suggested that electrodermal hyporeactivity has a high sensitivity and a high negative predictive value for suicide. The aim of the present study is to test the effectiveness and the usefulness of the EDOR® (ElectroDermal Orienting Reactivity) Test as a support in the suicide risk assessment of depressed patients.One thousand five hundred and seventy three patients with a primary diagnosis of depression, whether currently depressed or in remission, have been recruited at 15 centres in 9 different European countries. Depressive symptomatology was evaluated through the Montgomery-Asberg Depression Scale. Previous suicide attempts were registered and the suicide intent of the worst attempt was rated according to the first eight items of the Beck Suicide Intent Scale. The suicide risk was also assessed. During the EDOR® Test two fingers are put on gold electrodes and a moderately strong tone is presented through headphones now and then during the test. The EDOR® Test is able to register the electrodermal responses to those tones, along with the blood volume in the fingers. Each patient is followed up for one year in order to assess the occurrence of suicidal behaviors.Expected results would be that patients realizing a suicide attempt with a strong intent or committing suicide should be electrodermally hyporeactive in most cases and non-hyporeactive patients should show only few indications of death intent or suicides. Preliminary findings will be presented.Disclosure of interestThe participating centres received funding for this study by EMOTRA AB, Sweden.

Social withdrawal and suicide risk: A descriptive study

2016 ◽  
Vol 33 (S1) ◽  
pp. S175-S175 ◽  
Author(s):  
A. Malagon ◽  
D. Córcoles ◽  
E. Pérez ◽  
L. Mollà ◽  
D. Bergé ◽  
...  
Keyword(s):  
Child Abuse ◽  
Social Isolation ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Social Withdrawal ◽  
Small Sample Size ◽  
Age At Onset ◽  
Small Sample ◽  
Major Health Problem

IntroductionSocial withdrawal is a major health problem that has been related with higher morbidity and mortality rates. There are few studies about the relationship between suicidal behavior and social isolation.AimTo describe the existence of suicidal risk in subjects with social isolation.MethodParticipants were 187 subjects referred to a Crisis Resolution Home Treatment because of social isolation. The inclusion criteria were: home isolation, avoiding of social situations and relationships, for at least 6 months. Suicide risk was assessed by the item of the Severity of Psychiatric Illness, dividing in four groups (from absence to high suicide risk). Socio-demographic and clinical data were also analysed.ResultsMost cases (n = 132, 70.5%) had absence of suicide risk. They were predominantly young males in all groups. There were no statistically significant differences in sociodemographic or clinical variables. The mean age at onset of social isolation was lower in the high suicide risk group, having lower socially withdrawn period. This group had also lower rates of child abuse and suicide attempt history. The more frequent diagnosis in all groups was psychotic, affective and anxiety disorders. Those cases with mild and high suicide risk needed more frequently hospitalization.ConclusionsSocial isolated people attended by CRHT do not have high frequency of suicide risk. Cases with higher suicide risk are younger and have a shorter period of isolation. The absence of child abuse history or previous suicide attempts contrasts with previous suicidal behavior research. These data can be influenced by the characteristics of functioning of CRHT and the small sample size.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicidal Behavior in German Adolescents

2015 ◽  
Vol 43 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Joana Straub ◽  
Ferdinand Keller ◽  
Nina Sproeber ◽  
Michael G. Koelch ◽  
Paul L. Plener
Keyword(s):  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Present Sample ◽  
Manic Symptoms ◽  
Symptoms Of Depression ◽  
Adolescent Sample ◽  
History Of ◽  
Sum Scores

Objective: Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date. Methods: 1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior. Results: In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores. Conclusions: Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.

The effect of Zotepine on productive and negative symptoms in schizophrenic patients

1988 ◽  
Vol 3 (2) ◽  
pp. 125-130
Author(s):  
D.M. Dieterle ◽  
M. Ackenheil ◽  
H.P. Kapfhammer ◽  
F. Müller-Spahn
Keyword(s):  
Adverse Effects ◽  
Negative Symptoms ◽  
Suicide Attempts ◽  
Positive Effects ◽  
Antipsychotic Efficacy ◽  
Schizophrenic Patients ◽  
Dose Dependent ◽  
Low Dosage ◽  
Motor Disturbances

RésuméZotepine was studied in 15 schizophrenic patients over a period of 28 days with regard to its antipsychotic efficacy, effect on negative schizophrenic symptoms, tolerability and adverse effects. Nine patients received Zotepine in a high dosage of 230 mg/die±52 mg, 6 patients in a low dosage of 168 mg/die ± 18 mg. Two patients receiving the high dosage dropped out after 21 days because of worsening of symptomatology and suicide attempts. Zotepine had rapid antipsychotic effects with sedative properties during the initial days of treatment. Minimal adverse effects and extra-pyramidal motor disturbances as well as dose-dependent positive effects on negative schizophrenie symptoms were found.

scholarly journals Psycho-social factors associated with high depressive symptomatology in female adolescents and gender difference in adolescent depression: an epidemiological survey in China’s Hubei Province

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenzhe Sun ◽  
Junhua Mei ◽  
Yanyan Wang ◽  
Xin Zhao ◽  
Zhou Zhu ◽  
...  
Keyword(s):  
Middle School ◽  
Primary School ◽  
Social Factors ◽  
Adolescent Depression ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Education Level ◽  
Female Adolescents ◽  
Male Adolescents ◽  
And Gender

Abstract Background Exploring etiological clues to adolescent depression, especially in female adolescents, might be helpful to improve the social environment of female adolescents. The aim at this study is to explore psycho-social factors of female adolescents with high depressive symptomatology and gender differences in depressive symptoms among Chinese adolescents. Method We examined 4100 adolescents from Wuhan city and Jianli county via a cross-sectional study. Depressive symptomatology was screened through the Chinese version of Center for Epidemiology Studies Depression Scale. Multivariate logistic regression was performed to explore the factors related to high depressive symptomatology in female and male adolescents, respectively. Results The prevalence of high depressive symptomatology in female and male were 38.9 and 30.2% respectively. The psycho-social factors of high depressive symptomatology in female adolescents were age (Adjusted odds ratio [aOR] = 1.201, 95% confidence interval [CI], 1.076 ~ 1.341), single parent family (aOR = 2.004, 95%CI, 1.448 ~ 2.772) and fathers’ education level (compared to primary school and below, [Junior middle school, aOR = 0.641, 95%CI, 0.439 ~ 0.934; Senior middle school, aOR = 0.603, 95%CI, 0.410 ~ 0.888; College degree and above, aOR = 0.639, 95%CI, 0.437 ~ 0.936]). Conclusion Fathers’ education level was associated with high depressive symptomatology in female adolescents. Female adolescents whose father with primary school education or below deserves more attention. Further epidemiologic researches need to be conducted to explore the different risk factors between female and male adolescents in China.

Genetic Counselling in Psychiatric Disorder with High Suicide Risk

2017 ◽  
Vol 41 (S1) ◽  
pp. S101-S101
Author(s):  
D. Cozman ◽  
R. Moldovan ◽  
B. Nemes
Keyword(s):  
Suicidal Ideation ◽  
Genetic Counselling ◽  
Suicide Risk ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Past History ◽  
Mental Illnesses ◽  
Death Wishes ◽  
Suicidal Plans ◽  
The Impact

IntroductionA better understanding of the genomics of mental illnesses allowed genetic counselling to be provided to individuals with severe mental illness and their families.AimThe present study was aimed at assessing the efficacy of genetic counselling for severe mental illnesses with high suicide risk.MethodAssessment was performed before and after genetic counselling session. Measures used were evaluation of traumatic events in childhood, multidimensional scale for perception of social support (SMSSP), positive and negative affect schedule (PANAS-X), Brief Psychiatric Rating Scale (BPRS), Paykel questionnaire and Genetic Counselling Outcome Scale (GCOS). Paykel's questionnaire consists of five questions about suicidal thoughts and attempts, including: life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts. Intervention and assessment lasted approximately one and a half hour. Data from 48 patients was analysed.ResultsMean age of participants was M = 38.4, SD = 9.7, and the group was batter represented by females (57%). The participants had various diagnoses, 22% had schizophrenia, 36% bipolar disorder and 42% recurrent depressive disorder. Forty percent of participants reported suicidal ideation and 22,5% had a past history of suicide attempt. Genetic counselling had a direct positive influence upon GCOS specific items and reduced the Paykel scores among participants presenting with suicidal ideation.ConclusionGenetic counselling offers information about the disorder, the role of genetics and the impact of environmental factors. Preliminary data suggest that providing genetic counselling decreases the suicidal ideation frequency.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Incest: What do we Really Know about It?

1987 ◽  
Vol 21 (4) ◽  
pp. 430-440 ◽  
Author(s):  
R. Kosky
Keyword(s):  
Adverse Effects ◽  
Sexual Activity ◽  
Sexual Intercourse ◽  
Current Knowledge ◽  
Epidemiological Studies ◽  
Scientific Basis ◽  
Long Term Effects ◽  
Clinical Series ◽  
General Populations

The literature on incest is reviewed. Current knowledge rests on a very insecure scientific basis and has been mainly derived from small, highly selected clinical series. Recently, some important epidemiological studies of general populations have been reported, but the results of prevalence are inconsistent. Overall, however, it appears that incest, when defined in terms of sexual intercourse, occurs in less than 1% of the population, but other forms of intrafamilial sexual activity may affect 10% of females before they are 16 years of age. Some children are more at risk than others. Because information has generally been derived from court or treatment samples, we are unclear about the long-term effects of incest experiences but, overall, the impression is that incest has markedly adverse effects, especially if it is accompanied by violence and threats and is directed, as it usually is, at the young pre-pubescent child.

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