Resource Tag: INTERVIEWING IN PSYCHIATRY

This full version paper derives from clinical study in Massachusetts over an 18-year period. An abridged version appeared earlier. Paper theme: the value of formulation in understanding suicide risk & vulnerability rests on the psychoanalytic theory of dependency & narcissism. A theoretical prologue covers suicide & self objects. Psychodynamic formulation & errors & dangers in […]

The safety needs of the suicidal patient are paramount. Decisions concerning the admission of suicidal patients into the hospital are examined from three perspectives: issues related to the patient; issues related to the therapist; & issues related to the interaction between patient & therapist. The risks & benefits of a psychiatric inpatient program are discussed. […]

This article outlines a 12-centre European initiative & reports on a preparatory study restricted to a Swedish hospital. The study was based on a detailed quantitative registration of all examinations & interventions, as well as hospitalization, offered to a consecutive series of 97 suicide attempters. Reported results include demographic & clinical data, medical care, psychiatric […]

This chapter examines the role of the therapist in suicide prevention, addresses possible techniques for treatment, notes the impact of suicide on the therapist, describes potential errors that might inhibit positive contributions, & looks at transference and countertransference issues. The initial interview & dealing with symptomatology are also discussed. (30 Refs.)

Demographics and clinical data, based on interviews & questionnaire items from 581 initial psychiatric referrals, are described. The majority of referrals were single, unemployed females referred for depression, suicidal ideation/attempts & family problems. The implications of these findings & the development of community-based intervention programs are discussed.

Report describes mental health issues affecting Inuit women seen in psychiatric consultation. Recent public & governmental attention has focused on the emotional & behavioural sequelae of rapid cultural change, spousal assault, & sexual violence. The need for innovative, community-based treatment strategies in this population is emphasized.

This study was planned with the aim of approaching psychiaric admissions from a crisis point of view. Methods of assessment & intervention techniques were evaluated in accordance with crisis theory & crisis intervention principles. 281 emergency referrals were analyzed. Women were more often referred than men. The majority of patients were under age 50. Loss, […]

The forensic psychiatrist is sometimes asked to exclude that a person has a psychoactive substance use disorder. These evaluations require corroborated background information; inquiry into the history of substance use; & an examination of areas in which problems from substance use can occur, e.g. personal & psychiatric reactions (suicidal behaviour). Four case vignettes are provided […]

A study was conducted of all referrals to the emergency psychiatric service of a London hospital over 1 year. 53 individuals presented with a specific & spontaneous complaint of suicidal ideation without any accompanying act of self-harm. The main diagnoses in this group were personality disorders & alcohol dependence. Members were less likely to receive […]

59 deliberate self-poisoners were interviewed 12 months after a suicide attempt. Compared with nonrepeaters, repeaters had more often made previous suicide attempts, their index attempt was less serious, & they were more often in psychiatric treatment at index. At follow-up, repeaters more often expressed the need for professional mental health support. Repeated self-poisoning occurred despite […]

This study describes a group of outpatients who had threatened or attempted suicide & were brought to the attention of military psychiatrists. This group was compared with a similar number of nonsuicidal patients. The suicidal group were younger, had less time in service & were more frequently diagnosed with character disorders & immaturity reactions. The […]

This article outlines the elements of a psychiatric interview with an elderly patient. The author describes how to obtain a full history of the patient, including symptoms, present & past episodes of medical & psychiatric disorders, & family history. He also describes the elements of physical & mental status examination & family assessment. He concludes […]

For appropriate intervention with depressed or suicidal clients, counselors should gain an understanding of clients’ perspectives of religious values & attitudes, which at the moment of suicidal crisis may or may not be consonant with previously held religious tenets. Counselors should make appropriate inquiry within the counseling setting to determine whether religion has an inhibiting […]

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Recently there has been much public concern about suicide & the mental health of adolescents. Suicidal threats, depression & parental anxiety may lead families to present their youngsters to the family physician. This article addresses such issues as understanding & assessing these phenomena & the role of the general practitioner in their management. (25 refs.)

An approach is presented for using strengths to assist hospital treatment planning. Behavioural correlates of nonsymptomatic “coping moments” are uncovered by strength-focused interviewing. These coping-related behaviours then become treatment goals that emphasize the presence of adaptive coping rather than the absence of maladaptive symptoms. The cases of a 28-yr-old suicidal woman & a middle-aged depressed […]

This article outlines the characteristics & risk factors of suicidal patients, & provides evaluative techniques for physicians to use. The author begins by describing which patients need suicidal evaluation, & then details the interview technique. He outlines the personal & demographic risk factors of suicide (mental illness, age, sex, social & occupational factors, etc.) & […]

This article describes the most common drugs used by adolescents who attempt suicide, as well as how to gauge the seriousness of intent of a suicidal patient. The symptoms of depression are provided, as well as hints for interviewing the depressed adolescents, & a list of the stages of depression (as described by Mattsson). (VM)

This chapter discusses how a counsellor can assess the suicidal risk of a client. Guidelines for the suicidal diagnostic interview are presented to assist the counsellor in arriving at as immediate an assessment as possible. Diagnostic clues & questions to ask are provided. The authors then describe the suicidal crisis, what to do, & what […]

This article details the characteristics of adolescent suicide, including clinical symptoms, risk indicators, environmental & individual stressors, & measures of suicidal intent. The authors also discuss residential management of suicidal adolescents. They outline preacceptance assessment, psychiatric consultation, family assessment, treatment plans, social support, & school planning. They conclude by suggesting general preventative measures, such as […]

The Task Force on Youth Suicide reports on Recommendation 4 which involves supporting the delivery of suicide prevention services. This recommendation is subdivided into 8 parts including increasing the number of health care professionals specializing in mental health problems of young people & decreasing financial & legal barriers to care. An action plan is provided […]

Appendix “A” of Suicide Risk contains an outline for the examination of patients, similar to that used in the psychiatric department of the Massachusetts General Hospital. The first part is the clinical history, the second is a detailed mental state examination. (NBB)