Resource Tag: DECISION MAKING

Some studies have investigated the possible relationship between suicide attempts and impulsivity in patients with bipolar disorder. The objective of this study was to assess the relationship between neuropsychological and clinical aspects and suicide behavior in euthymic bipolar patients. The Iowa Gambling Task and the ConnerÕs Continuous Performance Test evaluated impulsivity in 95 euthymic bipolar […]

This article describes one hospital’s inpatient admission screening process. Through an interdisciplinary team of nurses, social workers, nursing care coordination, computer clinical analyst, staff education, & management, a prescreening tool/process was developed that identified medical patients with emotional or behavioural disorders & at risk for suicide. A 4-item suicide risk tool was piloted & revised. […]

Family members of patients with cancer may reveal to the medical team that they are considering suicide after their loved one dies. No literature is available indicating how to assess risk & to intervene with these individuals. The authors describe various warning signs & seek to improve awareness & approaches to suicide prevention. 5 cases […]

The authors review the literature related to patients who obtain a Do-Not-Resuscitate order in preparation for a suicide attempt & the ethical issues involved in mkaing a decision to resuscitate or not in these cases. The authors address the potential legal consequences of action or inaction & clinical issues to consider before such an order […]

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This book is written for counsellors & psychotherapists, & for any professional who uses counselling skills when supporting suicidal people. It has 6 main parts: the changing context of suicide; the prediction-prevention model, policy, & ethics; the influence of the organization; the client process; the practitioner process; & the practice of counselling with suicidal clients. […]

The authors undertook a comprehensive review of publications related to the topics antidepressants, suicide, suicidality, suicidal behaviour, & aggression. Based on the review, it was concluded that antidepressants, including selective serotonin reuptake inhibitors, carry a small risk of inducing suicidal thoughts & suicide attempts, in age groups below 25 years, the risk reducing further at […]

This study examined data on symptom patterns in the week prior to admission for suicide attempt in a nationwide representative sample of Italian patients. 230 patients (14.8%) in the sample had been admitted to a private or public psychiatric facility for a suicide attempt. No diagnosis was statistically related to admission after suicide attempt, once […]

152 primary care physicians were randomly recruited (53-61% of those approached) from 4 sites in northern California & Rochester, New York to participate in a study assessing the effect of a patient’s request for antidepressant medication on a physician’s prescribing behaviour. Standardized patients portraying 2 conditions & 3 antidepressant request types made 298 unannounced visits […]

This article describes the extent of juvenile offender suicide & protocols for intervening with this high-risk population. Procedures for crisis intervention are recommended & the step-by-step sequential Roberts’ 7 Stage Crisis Assessment & Crisis Intervention model is delineated & discussed. The article concludes with an examination of the extent to which suicide assessment & prevention […]

The authors proposed a four-square grid distinguishing true suicide from behaviours such as treatment termination & lethal noncompliance. One axis characterizes whether actions hasten death. The other identifies how the patient’s social & medical network collaborate in the decision-making process. Using chronic kidney disease to model intent & collaboration, treatment is framed within a paradigm […]

See #2010-0000 for another article on this study.

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This study explored the decision-making processes of medical examiners in the determination of child suicide. 94 American medical examiners completed a survey regarding those factors considered when making a child suicide determination, sources of information used, & considerations in acccident versus suicide classifications. Well-known risk factors such as suicide notes were considered by virtually all […]

When a client is at risk for suicide, important counselling decisions must be made. This article presents a process model for decision making in high-risk outpatient situations. It is proposed that counsellors attend to 2 key dimensions of these situations: the strength of the therapeutic alliance & the degree of suicide risk. Therapeutic actions are […]

Assessment of suicide risk is a challenging task which includes a psychopathological evaluation, consideration of socio-demographic & clinical variables, history of previous suicide attempts, & analysis of the psychological context. A high index of suspicion helps to avoid possible pitfalls in the assessment of suicide risk. Individuals with imminent risk of suicide need immediate & […]

The authors discuss the clinical challenges of distinguishing real from feigned signs of recovery. Whereas genuine clinical improvement is a process, sudden patient improvement is a suspect event. The atuhors discuss clinical indicators that distinguish the two. They emphasize the importance of gathering corroborating evidence through communications with staff & the patient’s family. Suicide risk […]

Over one year, 1,245 consecutive psychiatric patients from a Norwegian catchment area were included at index admission & reassessed in cases of readmission. After a mean follow-up period of 562 days, a total of 1,234 readmissions were reassessed. Outcome variables included acute readmissions & readmissions for suicide risk. 54% of the index admissions & 62% […]

This study found the timing of the American Food & Drug Administration recommendations was associated with trends in the use of paroxetine & fluoxetine by children with major depressive disorder who were initiating antidepressant treatment. However, no evidence of increases in outpatient visits (indicative of monitoring) among depressed children initiating antidepressant use was found. Release […]

This study determined whether higher suicide risk, defined as previous suicide attempt or suicide ideation, influenced the choice of antidepressants prescribed in an outpatient mental health unit. Data was analysed in terms of presence of suicide risk, gender, & whether bipolar II patients on venlafaxine were treated with mood stabilisers. Results showed a risk of […]

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Using an empirically based decision tree analysis for a large national sample of Veterans Affairs health system patients treated for depression, the authors identified subgroups with particularly high or low rates of suicide. 887,859 patients treated for depression between April 1999 & September 2004 were identified. The exploratory data analysis produced a decision tree with […]

The objective of this article is to provide family physicians with an approach to youth suicide prevention. A literature review was performed. Youth suicide might be prevented by earlier recognition & treatment of mental illness. Family physicians can & should screen for mental illness in youth; there are many diagnostic & treatment resources available to […]