Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: A register-based, nationwide multicentre study using propensity score matching.

The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. Our findings show a lower risk of repeated deliberate self-harm and general mortality in recipients of psychosocial therapy after short-term and long-term follow-up, and a protective effect for suicide after […]

Psychosocial treatment of depression and suicidality in adolescents.

Gene Ontology(2) Diseases(2) Depression is a common disorder among adolescents and is associated with a high risk of suicide. Suicide is the third leading cause of death among adolescents in the United States. Currently, there are only two evidence-based psychotherapies for adolescence depression: cognitive-behavioral therapy and interpersonal psychotherapy. Furthermore, psychosocial interventions that specifically target suicidal […]

Emotion dysregulation and negative affect: association with psychiatric symptoms.

Objective: A growing body of research focuses on the development and correlates of emotion dysregulation, or deficits in the ability to regulate intense and shifting emotional states. Current models of psychopathology have incorporated the construct of emotion dysregulation, suggesting its unique and interactive contributions, along with childhood disruptive experiences and negative affect, in producing symptomatic […]

Evidence-Based Practice in Suicidology: a Source Book

This edited book on evidence-based practice in suicidology is organized into 4 parts, beginning with the framework. The next section includes 9 chapters on evidence-based strategies for suicide prevention. Part 3 examines evidence-based approaches for specific disorders & behaviours. The final section is comprised of 2 chapters, including a commentary on perspectives in suicide research […]

Suicide risk assessment and management: a systematic evidence review for the clinical practice guidelines for emergency departments and mental health services project

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Suicide Prevention

This pocket-book includes the following chapters: Historical Review; Definitions; Epidemiology; Contributing Factors to Suicide; Mental Disorders & the Biological Substrate of Suicide; Psychosocial Influences on Suicidal Behaviour; An Evidence Based Management Approach; Initial Assessment & Management; Non-Pharmacological Approaches; Pharmacological Approaches; Broad Suicide Prevention Initiatives; Bereavement After Suicide; Frequently Asked Queations; & Conclusion. An appendix provides […]

Suicide in Alcohol-Dependent Individuals: Epidemiology and Management

This article reviews what the authors deem to be the essential epidemiological & clinical research in the areas of alcohol dependence & suicidal behaviour. On the basis of current data & clinical experience, they suggest the following principles for the management of alcohol-dependent individuals: suicidal threats or communications in emergency & other contacts be taken […]

Mental Health Service use Among Suicidal Adolescents: Findings From a U.S. National Community Survey

This study assessed patterns of mental health service use among adolescents who had attempted suicide & examined factors associated with their service use at individual, family, & community levels. Bivariate & multiple logistic regression analyses were conducted with data from 877 adolescents who had attempted suicide in the past 12 months. Less than half reported […]

Adolesents who Self-Harm: how to Protect Them From Themselves

When treating teenagers with self-harming thoughts & behaviour, it may be difficult to distinguish suicide attempts from self-injury without intent to die. Understanding adolescent self-harm, suicide risk assessment, & treatment options guides clinicians to appropriate interventions. Recognizing the need for aggressive treatment – including psychiatric hospitalization – is essential to keeping self-harming teenagers safe. (28 […]

Course and Predictors of Suicidality Over the First two Years of Treatment in First-Episode Schizophrenia Spectrum Psychosis

This study investigated the course of suicidal behaviour over the first 2 years of comprehensive, integrated treatment in 2 groups of patients with DSM-IV first episode schizophrenia spectrum psychosis, where 1 group was recruited through an early detection program. It has been shown previously that the rate of severe suicidal behaviour was lower in the […]

Depression in Adolescents: Current Treatments, Suicidality and Evaluation of Novel Treatment Strategies

Depression in the child & adolescent population has been an area of research for over 20 years. Among novel therapeutic strategies, transcranial magnetic stimulation has demonstrated the most favourable side effect profile. Until this time, there are no published suicide attempts associated with this treatment & it may offer an option that is not associated […]

Suicidality in Schizophrenia: Pharmacologic Treatment

The use of antipsychotic, antidepressant, anxiolytic, & mood stabilizing drugs to reduce the risk of suicide in schizophrenia is reviewed. There is significant evidence from mirror image, registry, & one controlled trial indicating clozapine can greatly reduce the risk of a suicide attempt, & most likely completed suicide, in patients with schizophrenia or schizoaffective disorder. […]

Suicidal Risk in Bipolar Disorder

Suicide rates in bipolar disorder patients average 0.4% per year, or more than 25-times higher than the general population average. Suicidal acts often occur early in the illness & in association with severe depressive & dysphoric-agitated mixed phases. Systematic consideration of risk factors can enhance the assessment of potentially suicidal patients. Several short-term interventions are […]

Interventions in Suicidal Alcoholics

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Interventions for Suicidal Youth: a Review of the Literature and Developmental Considerations

The degree to which interventions for suicidal behaviours have been developmentally tailored has varied widely. Published controlled studies of psychosocial treatment interventions for reducing adolescent suicidal behaviour are reviewed, with a particular emphasis on the developmental nuances of these interventions. In addition, developmental considerations important in the treatment of suicidal adolescents are discussed. There are […]

The Efficacy of No-Suicide Contracts With Clients in Counseling on an Outpatient Basis

Clients at 2 outpatient facilities who self-identified as having expressed suicidal thoughts or engaged in suicidal behaviours during some point in their counselling treatement were invited to participate in a survey to assess their perception of the relative effectiveness of 22 treatment methods in order to determine the perceived efficacy of no-suicide contracts as compared […]

Service Needs of Clients in Outpatient Substance-Use Disorder Treatment: a Latent Class Analysis

This study examined whether there are common classes of service needs among clients in outpatient substance-use disorder treatment. Data were derived from the National Treatment Improvement Evaluation Survey & focused on 2,256 clients in outpatient treatment. Latent class analysis was used to explore different class solutions. A four-class solution exhibited best fit. 14.0% of clients […]

Body Dysmorphic Disorder: Treating an Underrecognized Disorder

This article discusses body dysmorphic disorder, its prevalence, clinical features, diagnosis, & treatment. Treatment may include drug & psychological therapies. The cause of “Mr. H”, a 33-year-old single white male, with body dysmorphic disorder is used as illustration. Mr. H. had passive suicide ideation & had attempted suicide in the past. (42 refs.)

Psychosocial Interventions Following Self-Harm: Systematic Review of Their Efficacy in Preventing Suicide

This study examined whether additional psychosocial interventions following an episode of self-harm reduce the likelihood of subsequent suicide. A systematic review & meta-analysis of data from randomised controlled trials was conducted. Likelihood of suicide was compared by calculating the pooled root difference in the suicide rate with 95% confidence intervals. Suicide data was obtained from […]

Preventing Late-Life Suicide: 6 Steps to Detect the Warning Signs

This article describes an age-based psychiatric workup of the suicidal older patient, including factors to consider when screening for depressive symptoms, prescribing drug therapy, & determining the need for hospitalization. The 6-step screening interview includes: asking about a specific plan for suicide; gathering a history of prior suicidal behavior, including familial suicide; assessing social status; […]

Decline in Treatment of Pediatric Depression After FDA Advisory on Risk of Suicidality With SSRIs

This study used data from a large American pediatric cohort to examine patterns of diagnosis of depression, prescription of antidepressants, prescription of pharmacological alternatives to antidepressants, & use of psychosocial care before & after the Food & Drug Administration advisory was issued. From 1999-2004, pediatric diagnoses of depression increased from 3 to 5 per 1,000. […]

Clinical Management of Suicidality in the Elderly: an Opportunity for Involvement in the Lives of Older Patients

OBJECTIVE: To review the risk factors for suicide in the elderly and available interventions to avert this tragedy. METHOD: Systematic literature review, based on a PubMed search for studies in English. Included were randomized controlled trials (RCTs), controlled cohort studies, and case-control studies. Wherever possible, I reviewed papers dealing with suicide rather than suicide attempts […]

Managing Suicidality in Schizophrenia

OBJECTIVE: The primary objective of this review article is to provide a coherent, systematic synthesis of the literature on the management of suicidality in schizophrenia that is relevant to the front-line clinician. METHOD: Literature searches were conducted on MEDLINE (1996 to 2007) and PubMed (1993 to 2007), using the key words “schizophrenia” and “suicide,” as […]