scholarly journals Conductas suicidas en la adolescencia: Una guía práctica para la intervención y la prevención

2020 ◽  
Vol 24 (3) ◽  
pp. 217
Author(s):  
Jose Luis Pedreira
Keyword(s):  
Early Intervention ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Emergency Services ◽  
Preventive Intervention ◽  
Hospital Emergency ◽  
Who Criteria ◽  
Palabras Clave ◽  
Factores De Riesgo ◽  
Keywords Suicide

Abstract: Suicidal behavior in adolescence: A practical guide for intervention and prevention. In Spain, suicide rates have increased over the last ten years. The increase has been particularly significant among adolescents. This paper realizes a conceptual update of suicidal behavior, following WHO criteria. A review is carried out of the risk factors for suicidal behavior in adolescence, both biological, psychological and social, differentiating between concurrent causes, precipitating causes and underlying psychopathological process. In particular, a review of the concept of suicidal ideation in adolescence is carried out, as an entry key to develop early intervention and preventive intervention activities. Finally, a protocol is created for intervention and prevention from social, media, school, family and health systems, including intervention by hospital emergency services. Keywords: Suicide; adolescence; suicidal ideation; early intervention; prevention.Resumen: En España las tasas de suicidio han tenido un incremento durante los últimos diez años. Ese incremento ha sido particularmente significativo en la etapa de la adolescencia. En el presente trabajo se realiza una actualización conceptual de las conductas suicidas, siguiendo los criterios de OMS. Se realiza una revisión de los factores de riesgo hacia la conducta suicida en la adolescencia, tanto los biológicos, como los psicológicos y sociales, diferenciando entre causas concurrentes, causas precipitantes, causas desencadenantes y proceso psicopatológico subyacente. De forma particular se realiza una revisión del concepto de ideación suicida en la adolescencia, como llave de entrada para desarrollar actividades de intervención precoz y de tipo preventivo. Finalmente se realiza un protocolo para la intervención y la prevención desde los sistemas social, mediático, escolar, familiar y sanitario, incluyendo la intervención desde los servicios de urgencia hospitalaria. Palabras clave: Suicidio; adolescencia; ideación suicida; intervención precoz; prevención

scholarly journals COMPORTAMENTO SUICÍDA E ATENÇÃO PRIMÁRIA À SAÚDE

2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Micheli Leal Ferreira ◽  
Mara Ambrosina De Oliveira Vargas ◽  
Jeferson Rodrigues ◽  
Daiane Trentin ◽  
Laura Cavalcanti de Farias Brehmer ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Attempted Suicide ◽  
Primary Health ◽  
Factores De Riesgo ◽  
Suicide Attempted ◽  
Primary Care Professionals

Objetivo: Conhecer as evidências relativas ao comportamento suicida na atenção primária à saúde, em produções científicas nacionais e internacionais. Metodologia: Revisão integrativa da literatura de janeiro de 2012 a abril de 2017. Utilizaram-se os termos: “Suicídio”, “Tentativa de suicídio”, “Ideação suicida” e “Atenção Primária à Saúde” resultando em 35 artigos. Resultados: Predominam estudos com enfoque na avaliação da prevalência de comportamento suicida; na descrição/avaliação da eficácia na prevenção/detecção de pessoas com comportamento suicida; e na identificação do perfil/fatores de risco ou proteção de pessoas com comportamento suicida que utilizaram a atenção primária. Evidenciou a necessidade em estudos com destaque à atenção primária à saúde, principal porta de entrada da pessoa em sofrimento. Conclusão: Uma lacuna importante a ser preenchida é a carência de estudos que enfoquem a identificação/desenvolvimento de estratégias de sensibilização/ capacitação dos profissionais da atenção primária para intervenção/prevenção ao comportamento suicida.DESCRITORES: Suicídio; Tentativa de suicídio; Ideação suicida; Atenção Primária à Saúde.SUICIDAL BEHAVIOR AND PRIMARY HEALTH CARE: AN INTEGRATIVE REVIEWObjective: To know the evidence regarding suicidal behavior in primary health care in national and international scientific productions. Methodology: Integrative review of the literature from January 2012 to April 2017. The terms “Suicide”, “Attempted suicide”, “Suicidal ideation” and “Primary health care” were used, resulting in 35 articles. Results: Predominant studies focus on the evaluation of the prevalence of suicidal behavior; in the description / evaluation of effectiveness in the prevention / detection of people with suicidal behavior; and the identification of the profile / risk factors or protection of people with suicidal behavior who used primary care. It evidenced the need in studies with emphasis on primary health care, the main entry point of the suffering person. Conclusion: An important gap to be filled is the lack of studies that focus on the identification / development of awareness strategies / training of primary care professionals for intervention / prevention of suicidal behavior.Descriptors: Suicide; Attempted suicide; Suicidal ideation; Primary Health Care.COMPORTAMIENTO SUICIDIO Y ATENCIÓN PRIMARIA A LA SALUD: UNA REVISIÓN INTEGRATIVAObjetivo: Conocer las evidencias relativas al comportamiento suicida en la atención primaria a la salud, en producciones científicas nacionales e internacionales. Metodología: Revisión integrativa de la literatura de enero de 2012 a abril de 2017. Se utilizaron los términos: “Suicidio”, “Tentativa de suicidio”, “Ideación suicida” y “Atención Primaria a la Salud” resultando en 35 artículos. Resultados: Predominan estudios con enfoque en la evaluación de la prevalencia de comportamiento suicida; en la descripción / evaluación de la eficacia en la prevención / detección de personas con comportamiento suicida; y en la identificación del perfil / factores de riesgo o protección de personas con comportamiento suicida que utilizaron la atención primaria. Evidenció la necesidad en estudios con destaque a la atención primaria a la salud, principal puerta de entrada de la persona en sufrimiento. Conclusión: Una laguna importante a ser llenada es la carencia de estudios que enfoquen la identificación / desarrollo de estrategias de sensibilización / capacitación de los profesionales de la atención primaria para intervención / prevención al comportamiento suicida.Descriptores: Suicidio; Tentativa de Suicidio; Idea Suicida; Atención Primaria a la Salud.

Not at Imminent Risk

Crisis ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 459-463
Author(s):  
Kate Monaghan ◽  
Martin Harris
Keyword(s):  
Early Intervention ◽  
Suicidal Ideation ◽  
Intervention Strategies ◽  
Group Method ◽  
Narrative Approach ◽  
Complex Issue ◽  
Research And Practice ◽  
Client Group ◽  
Types Of Information ◽  
Imminent Risk

Abstract. Background: Suicide is a pervasive and complex issue that can challenge counselors through the course of their careers. Research and practice focus heavily on crisis management and imminent risk rather than early intervention strategies. Early intervention strategies can assist counselors working with clients who have suicidal ideation, but are not at imminent risk, or with clients whose risk factors identify them as having a stronger trajectory for suicidal ideation. Aims: This systematic literature review examines the current literature on working with clients with suicidal ideation who are not at imminent risk, to ascertain the types of information and strategies available to counselors working with this client group. Method: An initial 622 articles were identified for analysis and from these 24 were included in the final review, which was synthesized using a narrative approach. Results: Results indicate that research into early intervention strategies is extremely limited. Conclusion: It was possible to describe emergent themes and practice guidelines to assist counselors working with clients with suicidal ideation but not at imminent risk.

Serotonergic Genes and Suicidality

Crisis ◽  
2001 ◽  
Vol 22 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Lisheng Du ◽  
Gabor Faludi ◽  
Miklos Palkovits ◽  
David Bakish ◽  
Pavel D. Hrdina
Keyword(s):  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Tryptophan Hydroxylase ◽  
Association Studies ◽  
Receptor Gene ◽  
Brain Regions ◽  
Depressive Illness ◽  
Control Group ◽  
Serotonergic Activity ◽  
Completed Suicide

Summary: Several lines of evidence indicate that abnormalities in the functioning of the central serotonergic system are involved in the pathogenesis of depressive illness and suicidal behavior. Studies have shown that the number of brain and platelet serotonin transporter binding sites are reduced in patients with depression and in suicide victims, and that the density of 5-HT2A receptors is increased in brain regions of depressed in suicide victims and in platelets of depressed suicidal patients. Genes that code for proteins, such as tryptophan hydroxylase, 5-HT transporter, and 5-HT2A receptor, involved in regulating serotonergic neurotransmission, have thus been major candidate genes for association studies of suicide and suicidal behavior. Recent studies by our group and by others have shown that genetic variations in the serotonin-system-related genes might be associated with suicidal ideation and completed suicide. We have shown that the 102 C allele in 5-HT2A receptor gene was significantly associated with suicidal ideation (χ2 = 8.5, p < .005) in depressed patients. Patients with a 102 C/C genotype had a significantly higher mean HAMD item #3 score (indication of suicidal ideation) than T/C or T/T genotype patients. Our results suggest that the 102T/C polymorphism in 5-HT2A receptor gene is primarily associated with suicidal ideation in patients with major depression and not with depression itself. We also found that the 5-HT transporter gene S/L polymorphism was significantly associated with completed suicide. The frequency of the L/L genotype in depressed suicide victims was almost double of that found in control group (48.6% vs. 26.2%). The odds ratio for the L allele was 2.1 (95% CI 1.2-3.7). The association between polymorphism in serotonergic genes and suicidality supports the hypothesis that genetic factors can modulate suicide risk by influencing serotonergic activity.

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.

Head trauma in young recreational sledders: helmets are not compulsory in Italian law (Preprint)

2018 ◽  
Author(s):  
Stefania Barbieri ◽  
Elisa Bertoldi ◽  
Giulia Maria Cillo ◽  
Rosa Maria Gaudio ◽  
Rossella Snenghi ◽  
...  
Keyword(s):  
Head Trauma ◽  
Emergency Departments ◽  
Emergency Services ◽  
Mountain Biking ◽  
Hospital Emergency ◽  
Descriptive Data ◽  
Winter Sports ◽  
Helmet Use ◽  
Italian Law ◽  
Almost All

BACKGROUND Helmet use is now viewed as an essential safety measure in almost all sports involving a high risk of impact and head trauma, from horseback riding to mountain biking, rock climbing and winter sports such as skiing and snowboarding. For young skiers and snowboarders under the age of 14, the use of certified helmets is compulsory in Italian law, although no defined regulations exist for recreational sledding OBJECTIVE To review past and current regulations covering winter sports, to explore potential legal discrepancies in appraising factors related to helmet use in recreational activities by children under the age of 14, and to identify hazards connected with various types of sledding accidents METHODS Descriptive data of the cases of 16-year-old or younger adolescents injured while sledding without helmets were gathered from injury reports collected by ski patrols, pre-hospital emergency services and emergency departments, and compared with 53 cases of adolescents and children who went skiing and snowboarding wearing certified helmets, over two winter seasons (December to April, 2011-12 and 2012-13). Sledges were grouped into three categories:1) traditional wooden toboggans (hereafter called ‘traditional sleds’); 2) plastic sleds; 3) newly designed sleds (with inner tubes, plastic and hard foam sleds, snowskates, boardslides, runslides, snowblades, foam slides, etc.) RESULTS Descriptive data of the cases of 16-year-old or younger adolescents injured while sledding without helmets were gathered from injury reports collected by ski patrols, pre-hospital emergency services and emergency departments, and compared with 53 cases of adolescents and children who went skiing and snowboarding wearing certified helmets, over two winter seasons (December to April, 2011-12 and 2012-13). Sledges were grouped into three categories:1) traditional wooden toboggans (hereafter called ‘traditional sleds’); 2) plastic sleds; 3) newly designed sleds (with inner tubes, plastic and hard foam sleds, snowskates, boardslides, runslides, snowblades, foam slides, etc.) CONCLUSIONS Additional investigation of the actual dynamics of the accident, together with information on the sitting position and sled speed are required. Regulations should compel ski slope operators to improve the current level of control on sledding slopes.

CARACTERÍSTICAS PATOLÓGICAS Y EPIDEMIOLÓGICO-FORENSES DE LA MUERTE SÚBITA DE ORIGEN PULMONAR EN LA DIVISIÓN MÉDICO LEGAL III, AREQUIPA 2017-2019.

SCIENTIARVM ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 35-38
Author(s):  
Daysi M. Itusaca Ticona ◽  
◽  
Gladys E. Núñez Zevallos ◽  
Mercedes H. Nuñez Zevallos ◽  
◽  
...  
Keyword(s):  
Palabras Clave ◽  
Factores De Riesgo

La presente investigación tiene como objetivo identificar las características patológicas y epidemiológicas forenses de la muerte súbita de origen pulmonar en la División Médico Legal III, Arequipa, del año 2017 al 2019. Se revisaron los protocolos de necropsias de muertes naturales (no violentas), separando los casos de muerte de causa pulmonar que cumplieron criterios de selección. Se muestran resultados mediante estadística descriptiva. Durante el periodo de estudio de tres años se realizaron 2433 necropsias, de las cuales 144 casos fueron sospechosos de muerte súbita de origen pulmonar; y finalmente 86 fueron definidos como muerte súbita de origen pulmonar, con una incidencia anual de 35.35 casos por cada 1000 necropsias al año en el periodo de estudio. El 68.60% de casos fueron varones y 31.40% mujeres, con edad promedio de 66.66 ± 19.73 años. El lugar de fallecimiento registrado fue el domicilio en 45.35%, el 22.09% falleció en la vía pública, 19.77% en hospital. No se identificaron factores de riesgo en 56.98% de casos; en 12.79% de casos hubo antecedente de diabetes, en 11.63% de obesidad, y en 5.81% de fallecidos se encontró inmovilización. La etiología de la muerte súbita pulmonar identificada en 87.21% de casos fue la neumonía, en 3.49% hubo absceso pulmonar, en 3.49% de fallecidos se identificó infarto pulmonar y en la misma proporción tromboembolismo pulmonar, y en 2.33% de casos hemoptisis. Se concluye que existe una frecuencia relativamente alta de muertes súbitas de origen pulmonar, afectando a personas de la tercera edad con predominio de neumonías. Palabras clave: Muerte súbita pulmonar - autopsias - neumonía.

scholarly journals Self-Reported Suicidal Ideation as a Predictor of Suicidal Behavior Among Outpatients With Diagnoses of Psychotic Disorders

2019 ◽  
Vol 70 (3) ◽  
pp. 176-183 ◽  
Author(s):  
Gregory E. Simon ◽  
Bobbi Jo Yarborough ◽  
Rebecca C. Rossom ◽  
Jean M. Lawrence ◽  
Frances L. Lynch ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Psychotic Disorders

Individual Approaches to Prevention and Early Intervention

2012 ◽  
pp. 362-380
Author(s):  
Teresa M. Au ◽  
Caroline Silva ◽  
Eileen M. Delaney ◽  
Brett T. Litz
Keyword(s):  
Early Intervention ◽  
Small Group ◽  
Stress Disorder ◽  
Preventive Intervention ◽  
Behavioral Therapy ◽  
Empirical Support ◽  
Future Research ◽  
Preventive Interventions ◽  
Psychological Debriefing ◽  
Traumatic Exposure

This chapter provides an overview of individual and small group-based approaches for prevention and early intervention of posttraumatic stress disorder (PTSD). Using the Institute of Medicine's (IOM) classification system for preventive interventions of mental disorders (universal, selective, and indicated), we describe individual and small group early interventions and review the effectiveness of these strategies. Specifically, psychological debriefing, psychological first aid, and psychoeducation have been used as selective interventions targeting individuals exposed to trauma with varying degrees of success. However, there is strong empirical support for using cognitive behavioral therapy as an indicated preventive intervention to help symptomatic individuals in the weeks or months following traumatic exposure. A review of the literature also suggests that future research should explore different modes of delivery and devote more attention to determining the best time to intervene after traumatic exposure.

scholarly journals Una actualización en el tratamiento de la artritis reumatoide en pacientes con factores de mal pronóstico

Lux Médica ◽  
2019 ◽  
Vol 14 (41) ◽  
pp. 31-42
Author(s):  
Najany Andrea Ibarra Alvarado ◽  
Leslie Elizabeth Leiva Rodríguez ◽  
Diego Issac Tiscareño Flores ◽  
Giselle Adriana Torres Hernández ◽  
Ma del Carmen Terrones-Saldívar
Keyword(s):  
Forest Plot ◽  
Palabras Clave ◽  
Factores De Riesgo

Introducción: En la artritis reumatoide (AR) existe el proceso de destrucción del cartílago y del hueso, el cual se puede retardar con fármacos antirreumáticos modificadores del curso de la enfermedad, pero cuando fallan, se buscan otras maneras de dar solución a esta problemática, como lo es la terapia biológica, la cual hablaremos a lo largo de esta revisión sistematizada y buscaremos cumplir el objetivo propuesto. Material y métodos. Se hizo una búsqueda en la base de datos en: Scielo, Pubmed, Elsevier, Medline, cenetec, Medigraphic, UpToDate, Redalyc. Donde se seleccionaron aquellos ensayos clínicos, estudios comparativos, controlados, aleatorizados, que evaluaron las siguientes intervenciones: “Artritis Reumatoide”, “terapia biológica”, “bronquiolitis obliterante”, “efectos adversos”, “tratamiento”, “efectos secundarios”, “beneficios”, en el título, el resumen, contenido y/o las palabras clave. También se contemplaron los siguientes criterios de inclusión: pacientes mayores e igual a 40 años, nivel mundial, ambos sexos, raza no negra, con factores de riesgo. Resultados: De los 18 estudios finalmente seleccionados de acuerdo con los criterios de inclusión, diez estudios reportaron como desenlace la remisión de la enfermedad en un período igual o menor que un año de seguimiento; 4 de éstos lograron demostrar diferencias estadísticamente significativas al comparar terapia biológica versus medicamentos antirreumáticos convencionales. Conclusiones: En pacientes con AR y factores de mal pronóstico es recomendable el inicio de terapia biológica, ya que según se muestra en el diagrama de "Forest Plot" la significancia estadística de inducir respuesta y remisión es mayor en la terapia biológica que en los FARME (fármacos modificadores de la enfermedad). LUXMÉDICA AÑO 14, NÚMERO 41, MAYO-AGOSTO 2019, PP 31-42.

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