Depression and Suicide Risk in Hemodialysis Patients With Chronic Renal Failure

The demographic & psychological factors associated with depression among 200 end-stage adult hemodialysis patients in Taiwan were examined & the relationships between depression, anxiety, fatigue, poor health-related quality of life, & increased suicide risk were elucidated. Structural equation modelling was used to analyze the models & the strength of the relationship between variables & suicide […]

Differentiating Suicide From Life-Ending Acts and End-of-Life Decisions: a Model Based on Chronic Kidney Disease and Dialysis

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 […]

Renal Dialysis and Suicide Occurrence

This presentation discussed the psychiatric examination of chronic dialysis patients, all of whom had died by suicide or attempted suicide. The number of suicides & attempted suicides was compared with the frequency of suicidal behaviours in the total population. The conditions precipitating the suicidal acts were discussed. It was suggested a well-coordinated team, consisting of […]

Suicide in the United States End-stage Renal Disease Program

Suicide Influences and Factors: Physical Illness (IN: Macmillan Encyclopedia of Death and Dying, vol.2: L-Z, ed. by R Kastenbaum)

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Adolescents’ Adjustment to Chronic Hemodialysis

The author compares the adjustment of 18 adolescents on chronic hemodialysis to that of 63 adult patients on helodialysis. The adolescents were found to comply less well with the medical regimen, their vocational rehabilitation was significantly lower, & their social activities were more restricted. They were found to suffer more from the changes in body […]

Acute Renal Failure and Hearing Loss due to Sodium Bromate Poisoning: a Case Report and Review of the Literature

This article describes acute renal failure with hearing loss due to sodium bromate intoxication. A 48-year-old woman who ingested permanent wave neutralizer in a suicide attempt & developed anuria was admitted to hospital for hemodialysis. Bromate intoxication was carried out; she required maintenance dialysis 3 times a week. Irreversible severe sensorineural hearing loss continued & […]

Using Rational Suicide as an Intervention to Prevent Irrational Suicide

This paper sets forth the idea that using the concept of, and criteria for, rational suicide can be a clinically useful intervention even with people who may be irrational in their suicidality. Case examples are used to illustrate ways in which reviewing the criteria may help move a person away from an impulsive decision to […]

Reaching out to the Suicidal in Thailand (A Column From Befrienders International)

This article was also published in Befriending Worldwide, no.4, 1997, pp.4-5.

Suicide and Disease

This article presents a review of research studies examining psychiatric & medical diseases. Evidence is presented for medical illnesses with high & average suicide risk as well as general physical illnesses. While patients with serious illnesses generally show a high risk of suicide & a higher percentage of deaths from suicide, these studies often involve […]

Depression in Hemodialysis Patients

In a study of depression in patients with end-stage renal disease, findings included a 17.7% prevalence of minor depression & a 6.5% prevalence of major depression in 124 patients treated with hemodialysis. Vegetative symptoms were less useful for discriminating depressive patients than were the psychological symptoms of suicidal ideation, depressed mood, & discouragement. (20 ref)

The Hemodialysis Patient (IN: Suicide Theory and Clinical Aspects, ed. by L D Hankoff and B Einsidler)

This chawpter reviews daily life stresses, self-destructive behaviors, & suicide among hemodialysis patients. Attempted & completed suicide occur at a much greater rate in the dialysis population. The debate as to what constitutes suicidal behavior in dialysis patients is discussed & management considerations are presented. (CM)

Setting up a Program for Crisis Prevention in Renal Transplant Patients

The authors present the many reasons why supportive psychotherapy should be made available to renal transplant patients. Areas causing anxiety to transplant patients are stated as: conflict regarding the expense of such treatment; guilt toward the donor; disturbed body image; fear of organ rejection; change in social relationships; & the prospect of leading a normal […]

Failure of Dialysis Therapy in Potassium Dichromate Poisoning

Describes the clinical course leading to death of a patient following an acute oral ingestion of potassium dichromate. Supportive treatment included a 4-hour period of hemodialysis followed by a 1-hour period of charcoal hemoperfusion. Neither treatment altered the progression or outcome of this intoxication. Concludes that the ingestion of potassium dichromate is highly toxic & […]

Diagnosis and Treating the Depressed Hemodialysis Patient

The depression often experienced by hemodialysis patients who survive under precarious circumstances & must confront profound changes in lifestyle & psycho-social-sexual functioning is discussed in this article. It is emphasized that careful differential diagnosis & vigorous treatment are essential in optimizing quality of life & suggests that intervention should include both antidepressant drugs & psychotherapy […]

Sudden Death in Hemodialysis Patients

Hemodialysis patients may die suddenly & unexpectedly from a number of causes. The author discusses some of these causes, dividing them into those due directly to & occurring during hemodialysis, those deaths occurring while the patient is not undergoing dialysis, & those deaths that may occur at any time. The second group includes suicidal causes […]

Psychological Complications of Dialysis: Psychonephrology to the Rescue.

Renal dialysis patients may have major problems adjusting psychologically to their illness & its treatment. Norman Levy, MD, has developed the concept of “psychonephrology” – the study of psychological factors experienced by dialysis & transplant patients. He believes psychiatrists & other behavioral personnel should play an important role in assisting patients & staff to adjust […]

Hemodialysis for Methyprylon (Noludar) Poisoning

The authors present a case of methyprylon (No ludar) overdose treated with extracorporeal hemodialysis. Dramatic clinical improvement was shown during the 9 hour period of dialysis with serum methyprylon levels decreasing from 4 to 0.4 mg/ml. Less than 10% of the ingested methyprylon was recovered from the bath. Dialysis of the toxic metabolites of the […]

Diagnosis of Depression in Patients With End-Stage Renal Disease

To evaluate the variability in the diagnosis of depression in patients receiving maintainance therapry for end stage renal disease. A study of 60 randomly selected patients was conducted. Research methodology is provided. 47% were classified as depressed by the BDI ; 17% & 5% were determined to be depressed according to the MACL & DSM-III […]

The Decision to No Longer Live On Chronic Hemodialysis

Most patients receiving chronic hemodialysis consider withdrawing from it if the “quality of life” available to them &/or their families is not sufficient. It would benefit most patients to openly discuss this option with the staff early in the program, thus making it a legitimate topic for discussion later when they may consider it more […]

Chronic Dialysis Patients: Suicide Incidence Rates. I

In this letter to the editor, published in the October 1971 issue of the American Psychiatric Journal, epidemiologist George Chu disputes the interpretation of statistical evidence of suicide rates presented in the Abram & Moore study, “Suicidal Behavior in Chronic Dialysis Patients” (The Journal, March 1971). (NBB)

Drs. Abram and Moore Reply

Drs. Abram & Moore defend the information contained in their article “Suicidal Behavior in Chronic Dialysis Patients”, responding to criticism contained in letters to the Editor, American Psychiatric Journal, Oct 1971. They point out the difficulties experienced in collecting necessary data, & challenge epidemiologists to carry out more sophisticated studies.(NBB)

Psychological Maladjustment in Renal Dialysis Patients

Psychiatric impairment in chronic hemodialysis patients is higher than the rate in the general population, & higher in adults than in children. This brief review of the literature on the incidence of psychiatric maladjustment in hemodialysis patients indicates a need for primary preventive psychiatric treatment in dialysis clinics.