Trials for new antidepressants leave out suicidal patients, show little benefit

2021 ◽  
Vol 23 (7) ◽  
pp. 1-3
Author(s):  
Alison Knopf
Keyword(s):  
Suicidal Patients

Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera
Keyword(s):  
Risk Factor ◽  
Suicidal Ideation ◽  
Inpatient Treatment ◽  
Improve Method ◽  
Sleep Problems ◽  
Psychiatric Inpatients ◽  
Poor Sleep ◽  
Treatment Termination ◽  
Suicidal Patients ◽  
The Relationship

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Facing a Patient Who Seeks Help After a Suicide Attempt

Crisis ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 110-122 ◽  
Author(s):  
Inês Areal Rothes ◽  
Margarida Rangel Henriques ◽  
Joana Barreiros Leal ◽  
Marina Serra Lemos
Keyword(s):  
Health Professionals ◽  
Suicide Attempts ◽  
Self Report ◽  
Suicidal Patient ◽  
Emotional Difficulties ◽  
Specific Training ◽  
Patient Suicide ◽  
Professional Groups ◽  
Professional Characteristics ◽  
Suicidal Patients

Background: Although intervention with suicidal patients is one of the hardest tasks in clinical practice, little is known about health professionals’ perceptions about the difficulties of working with suicidal patients. Aims: The aims of this study were to: (1) describe the difficulties of professionals facing a suicidal patient; (2) analyze the differences in difficulties according to the sociodemographic and professional characteristics of the health professionals; and (3) identify the health professionals’ perceived skills and thoughts on the need for training in suicide. Method: A self-report questionnaire developed for this purpose was filled out by 196 health professionals. Exploratory principal components analyses were used. Results: Four factors were found: technical difficulties; emotional difficulties; relational and communicational difficulties; and family-approaching and logistic difficulties. Differences were found between professionals who had or did not have training in suicide, between professional groups, and between the number of patient suicide attempts. Sixty percent of the participants reported a personal need for training and 85% thought it was fundamental to implement training plans targeted at health professionals. Conclusion: Specific training is fundamental. Experiential and active methodologies should be used and technical, relational, and emotional questions must be included in the training syllabus.

Outreach Psychiatric Emergency Service

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot
Keyword(s):  
General Practitioner ◽  
General Hospital ◽  
Suicidal Behavior ◽  
Emergency Service ◽  
Attempted Suicide ◽  
Emergency Services ◽  
Psychiatric Emergency ◽  
Psychiatric Emergency Services ◽  
Psychiatric Emergency Service ◽  
Suicidal Patients

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

Legal Aspects of Treating Suicidal Patients

1983 ◽  
Author(s):  
A Berman ◽  
◽  
R. Cohen-Sandler
Keyword(s):  
Legal Aspects ◽  
Suicidal Patients

Assessment and Treatment of Suicidal Patients

1997 ◽  
Vol 337 (13) ◽  
pp. 910-915 ◽  
Author(s):  
Robert M.A. Hirschfeld ◽  
James M. Russell
Keyword(s):  
Assessment And Treatment ◽  
Suicidal Patients

scholarly journals Night-nursing and Supervision in Asylums

1899 ◽  
Vol 45 (191) ◽  
pp. 713-724
Author(s):  
F. Ashby Elkins ◽  
Jas. Middlemass
Keyword(s):  
Essential Feature ◽  
Practical Experience ◽  
Free Play ◽  
Hospital Ward ◽  
The Other ◽  
The Past ◽  
First Results ◽  
Suicidal Patients ◽  
Selection Of

We think it will be generally acknowledged that the problem which the treatment of noisy, destructive, and dirty patients sets to their medical officers is greatest as regards their management at night. It is then undoubtedly that noise, destructiveness, and dirty habits have the greatest chance of getting free play, and it is then that the efforts for reformation have to be greatest. If these efforts are successful considerably more than half the problem will have been solved. It is to this part of the question, viz. the supervision of such patients during the night, that we desire in this paper to direct attention. At the outset it may be stated that our proposals are not theoretical. They are the result of practical experience gained during the past four years in the Sunderland Asylum. The special arrangements we propose to describe were instituted by one of us at the opening of the institution four years ago. At first a few cases were dealt with tentatively, but, as the first results were so encouraging, the number of cases was gradually increased, until all the patients who were restless, noisy, destructive, or of dirty habits came without exception to be dealt with. The asylum, situated at Ryhope, is a small one, containing only 350 beds, and on this account, as well as because it was new, it was conveniently suited for such an experiment. It may be well before going further to describe the arrangements now in existence there. There are 175 beds for each sex, made up as follows:—45 single rooms, one fully padded, and 2 half-padded; 2 small dormitories of 7 each, 2 of 13 each, 2 of 19 each, and 2 of 26 each. In the last two there is a night attendant, and one also in one of the dormitories for 19, which is the hospital ward. There is, in addition, a head night attendant who visits the patients in these dormitories and also all the remaining patients every hour, or oftener when necessary. There are thus 4 of a night staff for 175 patients. Though this is probably a large proportion compared to most public asylums, it is not claimed as a new departure in asylum management, as we are aware that in a number of asylums the advantage of having a large night staff is fully realised and acted on. The essential feature of the arrangements at Ryhope, to which we wish to direct attention, is the selection of cases placed in dormitories under constant supervision. Of course, all epileptics and suicidal patients are placed there. But, in addition, all recent cases of whatever kind, all dirty and destructive cases, and those who sleep badly and are in consequence inclined to chatter or be noisy, are also placed under constant supervision. Looked at from the other side, all single rooms and dormitories not under constant supervision are reserved for quiet and well-behaved patients who do not require any special attention during the night. This plan has been found to work exceedingly well, and since it was organised we have never had occasion to think of adopting any other. Another testimony to its effectiveness is that those of the staff who have the actual supervision of the patients and have had experience in other asylums are unanimous in their opinion that the arrangement is a very decided improvement. This opinion, let it be observed, is not based on the ground that now their duties are lighter than they were, because, as a matter of fact, they are more onerous.

Classification of "suicidal' patients.

1954 ◽  
Vol 18 (5) ◽  
pp. 359-362 ◽  
Author(s):  
Albert Rosen ◽  
William M. Hales ◽  
Werner Simon
Keyword(s):  
Suicidal Patients
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