Mental disorders and suicide in Northern Ireland

1997 ◽  
Vol 170 (5) ◽  
pp. 447-452 ◽  
Author(s):  
Tom Foster ◽  
Kate Gillespie ◽  
Roy McClelland
Keyword(s):  
Health Care ◽  
Northern Ireland ◽  
Mental Disorder ◽  
Health Care Professionals ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Axis Ii ◽  
Current Axis ◽  
Axis I ◽  
A Current

BackgroundThe aim of this part of the Northern Ireland Suicide Study was to investigate the prevalence of DSM - III - R axis I (clinical syndrome) and axis II (personality) disorders among suicides (14 years and older) in Northern Ireland during a one-year period.MethodA psychological autopsy study based on a variety of documentary sources and interviews with bereaved informants and health care professionals.ResultsNinety per cent of suicides (106/118) had a current axis I and/or an axis II mental disorder. At least one current axis I disorder was diagnosed in 86% of suicides (102/118), and at least one axis II disorder was diagnosed in 44% (52/118). Suicides under 30 years (92% male) were less likely to have a current axis I disorder (68%; 26/38) than those 30 years and older (95%; 76/80). Psychiatric comorbidity was present in 55% of suicides (65/118). The time between the last contact with a health care professional and death was greater among suicides under 30 years and male suicides.ConclusionsNotwithstanding the aetiological complexity of suicide, the prevention, recognition and treatment of mental disorder will continue to play key roles in suicide prevention.

Risk factors for suicide independent of DSM–III–R Axis I disorder

1999 ◽  
Vol 175 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Tom Foster ◽  
Kate Gillespie ◽  
Roy McLelland ◽  
Chris Patterson
Keyword(s):  
Risk Factors ◽  
Mental Disorder ◽  
Previous History ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Axis Ii ◽  
Estimated Risk ◽  
Independent Risk Factors ◽  
Axis I ◽  
Risk Factors For Suicide

BackgroundThe vast majority of suicides suffer from at least one mental disorder at the time of death.AimsTo identify risk factors for suicide, particularly those independent of current DSM–III–R Axis I disorder(s)MethodA case–control psychological autopsy study comparing suicides with matched community controls.ResultsIndependent risk factors for suicide included: Axis II (personality) disorder (particularly antisocial, avoidant and dependent); at least one of 12 life events (from the List of Threatening Experiences) during the previous 52 or 4 weeks (in particular, a ‘serious problem with close friend, neighbour or relative’); current unemployment; previous history of deliberate self-harm; and contact with a GP within 26 weeks. Relative to individuals with no current mental disorder, the estimated risk of suicide in those with Axis I–Axis II comorbidity (OR 346.0) was significantly greater than that in those with Axis I disorder(s) only (OR 52.4)ConclusionsSuicide risk assessment may be enhanced by enquiry about the aforementioned independent risk factors, and attention to Axis I–Axis II comorbidity.

A Pilot Study of the Suicide Victim’s Last Contact with a Health Professional

Crisis ◽  
2008 ◽  
Vol 29 (2) ◽  
pp. 96-101 ◽  
Author(s):  
Brian Draper ◽  
John Snowdon ◽  
Marianne Wyder
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Symptoms Of Depression ◽  
The Family ◽  
Full Study ◽  
Family Informants ◽  
Made In

Suicide victims frequently have contact with health care professionals in the months before death. The primary aims of this pilot psychological autopsy study were to determine the feasibility of undertaking a full study and to describe the characteristics of the last health care professional contacts with suicide victims aged > 34 years. We interviewed the informants of 52 suicides. Interviews were obtained from 37 health care professionals who had contact with 28 of the suicides during the 3 months before death. The primary reasons for the last contact with the health care professional were mental health (62%), physical health (22%), and social (14%). 87% of health care professional contacts occurred within 1 month of death. Symptoms of depression were noted in 49% of health care professional contacts. Consensus psychological autopsy diagnoses of depression were made in 64% of suicide victims. Overall suicide risk was assessed by 38% of health care professionals during their last contact. This was more likely to occur when the deceased presented as depressed, was aged < 60 years or seen by a psychiatrist. None was assessed to be suicidal. The family informants regarded nine of the suicide victims to have been suicidal before death but informed a health care professional in only one third of the cases. Critical information that might have altered the management is not often accessed from family members.

Les motifs du suicide gériatrique: une étude exploratoire

2003 ◽  
Vol 22 (2) ◽  
pp. 197-205
Author(s):  
Luc Legris ◽  
Michel Préville
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Professionals ◽  
Basic Needs ◽  
The Elderly ◽  
Elderly Persons ◽  
Need To Belong ◽  
Psychological Autopsy ◽  
Structured Interviews ◽  
Care System

ABSTRACTFive semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.

scholarly journals Being left-behind, mental disorder, and elderly suicide in rural China: a case–control psychological autopsy study

2018 ◽  
Vol 49 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Liang Zhou ◽  
Guojun Wang ◽  
Cunxian Jia ◽  
Zhenyu Ma
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Mental Disorder ◽  
Life Events ◽  
Stressful Life Events ◽  
Case Control ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Left Behind ◽  
Elderly Suicide

AbstractBackgroundSuicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population.MethodsThis matched case–control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support.ResultsA total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61–10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09–17.95), depressive symptoms (OR 1.34, 95% CI 1.21–1.48), and mental disorder (OR 6.28, 95% CI 1.75–22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support.ConclusionsUnstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.

Nurses See “The Big Picture”: Addressing Climate Change as a Social Determinant of Global Health

2016 ◽  
Vol 22 (4) ◽  
pp. 243-248 ◽  
Author(s):  
Bethany Divakaran ◽  
Shanda Lembeck ◽  
Rachel Kerr ◽  
Hannah Calmus ◽  
Teddie Potter
Keyword(s):  
Climate Change ◽  
Health Care ◽  
Health Care Professionals ◽  
Social Determinant ◽  
Future Generations ◽  
Big Picture ◽  
Role Of Nursing ◽  
Taking Action ◽  
A Current

Although it is well known that health is influenced by social determinants, climate change is an underrepresented determinant of health within nursing and health care literature, curriculum, and practice. There is urgent need to recognize climate change as a current and future threat to human and environmental health. This article describes the role of nursing in taking action on climate change now and in the future. The profession of nursing, with its ongoing commitment to social justice and its unique position to collaborate with patients and other health care professionals, is particularly well situated to activate change to protect and promote the health of individuals, populations, and future generations.

Quality of life and subthreshold obsessive-compulsive disorder

2007 ◽  
Vol 19 (6) ◽  
pp. 357-361 ◽  
Author(s):  
Arianna Goracci ◽  
Mirko Martinucci ◽  
Anastassia Kaperoni ◽  
Andrea Fagiolini ◽  
Chiara Sbaragli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Therapeutic Interventions ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Compulsive Disorder ◽  
Residential Population ◽  
Current Axis ◽  
Axis I

Objective:This study investigates the relationship between subthreshold obsessive-compulsive disorder (OCD) and quality of life (QoL) in a sample from the Italian general population.Methods:A sample of 202 psychiatrically healthy (defined as absence of current axis I and axis II disorders) subjects was recruited by word of mouth from the residential population in the Siena, Salerno and Milano municipalities (Italy). All study subjects completed the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Questionnaire for Obsessive-Compulsive Spectrum (OBS-SR), which explore a wide array of threshold and subthreshold OCD symptoms, behaviours and traits. A diagnostic assessment was conducted to exclude the presence of DSM-IV axis I and axis II disorders using the Mini International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-III-R personality disorders, respectively.Results:A statistically significant correlation was found between the OBS-SR total score and the Q-LES-Q domains of physical health, subjective feelings, work, school, social relationships and general activities. There was also a statistically significant correlation between several Q-LES-Q and OBS-SR domains.Conclusions:The presence of subthreshold OCD is correlated with poorer QoL. More research is needed to evaluate if specific therapeutic interventions targeting subthreshold obsessive-compulsive symptoms can lead to a significant improvement in the QoL of the affected individuals.

scholarly journals Inhaler Technique Training and Health-Care Professionals: Effective Long-Term Solution for a Current Problem

2014 ◽  
Vol 59 (11) ◽  
pp. 1716-1725 ◽  
Author(s):  
I. A. Basheti ◽  
E. A. Qunaibi ◽  
S. A. Hamadi ◽  
H. K. Reddel
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Current Problem ◽  
Inhaler Technique ◽  
A Current

scholarly journals Emotion Regulation Difficulties And Psychopathology In Bariatric Surgery Candidates

2021 ◽  
Author(s):  
Rachel Strimas
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Emotion Regulation ◽  
Eating Disorder ◽  
Psychiatric Disorder ◽  
Difficulties In Emotion Regulation ◽  
Current Axis ◽  
Axis I ◽  
A Current

Evidence suggests high rates of psychiatric disorders in bariatric surgery candidates (e.g., Kalarchian et al., 2007; Mitchell et al., in press), although no rigorous studies have examined the prevalence in a Canadian sample. As such, the first purpose of this study was to assess the prevalence of Axis I disorders, and associations with quality of life, in a sample of consecutively referred bariatric surgery candidates at the Toronto Western Hospital Bariatric Surgery Program. In light of emerging evidence linking emotion regulation difficulties with diverse psychiatric symptoms, the second purpose of this study was to examine whether emotion regulation difficulties were common or specific determinants of mood, anxiety, and eating psychodiagnostic categories, as such information would help inform interventions. Three hundred and twenty-one bariatric surgery candidates (80.1% female; M age = 44.37 years) were assessed using a structured psychodiagnostic interview and completed questionnaires of health-related quality of life and emotion regulation difficulties. Results indicated that 54.5% of patients met DSM-IV-TR criteria for a lifetime psychiatric diagnosis and 18.4% met criteria for a current psychiatric disorder. Major depressive disorder was the most common lifetime psychiatric disorder and binge eating disorder was the most prevalent current psychiatric disorder. Compared to patients without a current Axis I disorder, participants diagnosed with a current Axis I disorder reported significantly worse functioning on most mental and physical health domains (p’s < .01). Overall, a series of regression analyses revealed that difficulties regulating emotions accounted for unique variance in current mood and anxiety disorder status (p’s < .001). Difficulties in emotion regulation were not significantly associated with current eating disorder status after Bonferroni correction. Taken together, these results confirm the high rates of psychiatric disorders in a Canadian sample of bariatric surgery candidates and provide evidence for associated functional health impairment. The data also add to the growing body of literature demonstrating emotion regulation difficulties across psychodiagnostic categories and are consistent with suggestions that psychosocial interventions for bariatric patients might benefit from directly targeting difficulties in emotion regulation. Further study of these associations is needed to replicate these findings and elucidate how difficulties in emotion regulation interact with psychopathology to affect patients’ post-operative outcomes.

The Relationship of Personality Disorders and Axis I Clinical Disorders

2012 ◽  
pp. 236-259 ◽  
Author(s):  
Paul S. Links ◽  
Jamal Y. Ansari ◽  
Fatima Fazalullasha ◽  
Ravi Shah
Keyword(s):  
Personality Disorders ◽  
Clinical Utility ◽  
Future Research ◽  
Axis Ii ◽  
Clinical Disorders ◽  
Current Axis ◽  
Single Category ◽  
Axis I ◽  
Relationship Of ◽  
The Relationship

The purpose of this review is (a) to study and systematically review the recent literature examining the co-occurrence and relationships between Axis I psychiatric disorders and Axis II personality disorders (PDs), specifically the five originally proposed for DSM- 5, and (b) to consider the clinical utility of the current Axis I and II approach in DSM-IV-TR. Community surveys or prospective cohort studies were reviewed as a priority. Our review indicates that the associations between clinical disorders and PDs clearly varied within each disorder and across the five PDs. Our understanding has advanced, particularly related to the clinical utility of comorbidity; however, it seems premature to conclude that comorbidity is best conceptualized by having all disorders in a single category or by deleting disorders so that comorbidity no longer occurs. Our review suggests some priorities for future research into comorbidity such as including PDs in future multivariate comorbidity models.

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