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Antidepressants and suicide prevention in Hungary

ACTA PSYCHIATRICA SCANDINAVICA 2001年第3期103卷 238-238页

作者： Rihmer, Z Kalmár, S Belsö, N Natl Inst Psychiat & Neurol H-1281 Budapest 27 Hungary Semmelweis Hosp Dept Psychiat H-6400 Kiskunhalas Hungary

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Suicide among eminent artists

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PSYCHOLOGICAL REPORTS 1999年第1期84卷 291-301页

作者： Preti, A Miotto, P CMG Psychiat Branch I-09129 Cagliari Italy

To evaluate suicide risk by profession among eminent artists data from Garzanti's Encyclopaedia, a broad biographical repertory, were used. Six categories in the visual and literary arts were compared: architects, painters, sculptors, writers, poets, and playrights. Only people whose deaths occurred in the 1800s or 1900s were included since it is likely that underestimation of suicide has been lower in the more recent centuries. A total of 59 suicides were observed in a sample of 3,093 people: this corresponds to a ratio of 1.90%. Suicides were 51 among men (ratio 1.75%) and 8 among women (ratio 4.30%). The comparison by profession indicates that poets and writers exceed the mean suicide ratio of the sample. Painters and architects, conversely, have a clearly lower risk than the mean. Mean age of suicides was 44 yr, (SD=12), with writers being slightly older (48 yr., SD=12) than other artists. Artists who died of causes other than suicide reach a mean of 65 yr. (SD=10). Suicide among artists seems to have a peculiar pattern, clearly different from the pattern of the general population, wherein suicide risk is higher among men and older people. Adverse financial circumstances and the stress attributed to rejection of personal products may contribute to the specific risk of suicide among artists. The link between mental disorders. such as manic-depression, which imply a higher risk of suicide, and creativeness is discussed as a contributing factor.

关键词：艺术文学职业自我伤害行为/心理学自杀/统计学和数值数据女(雌)性人类男(雄)性中年人

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Psychosis and functioning as risk factors for later suicidal activity among schizophrenia and schizoaffective patients: A disease-based interactive model

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SUICIDE AND LIFE-THREATENING BEHAVIOR 1999年第1期29卷 10-24页

作者： Kaplan, KJ Harrow, M Michael Reese Hosp & Med Ctr Suicide Res Ctr Chicago IL 60616 USA Wayne State Univ Detroit MI USA Univ Illinois Dept Psychiat Chicago IL 60612 USA Univ Illinois Dept Psychol Chicago IL 60612 USA

The present research explores the relationship of positive symptoms, negative symptoms, and posthospital functioning to subsequent suicidal behavior over a 7 1/2-year period, and examines whether these patterns vary with diagnosis. The results support a multifactor model of suicide risk. Both psychosis and poor functioning show some relationship to later suicidal activity for both schizophrenic and schizoaffective patients. Psychosis may remain a risk factor for suicidal activity for schizoaffective patients, even when functioning is partialed out. This is in contrast to the schizophrenia patients, for whom functioning seems to mediate the effects of psychosis on later suicidality. In general, adequacy of overall posthospital functioning mediates the effects of some risk factors on suicidal activity within different diagnostic groups.

关键词：发病年龄卡方分布共病现象妄想/流行病学随访研究幻觉纵向研究情绪障碍/诊断情绪障碍/流行病学违拗症试验预期值精神病状态评定量表/标准精神病/流行病学危险因素精神分裂症/诊断精神分裂症/流行病学自杀/预防和控制自杀/统计学和数值数据自杀未遂/统计学和数值数据成年人女(雌)性人类男(雄)性

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Sex differences in adolescent suicides in Norway, 1990-1992

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SUICIDE AND LIFE-THREATENING BEHAVIOR 1999年第4期29卷 295-308页

作者： Groholt, B Ekeberg, O Wichstrom, L Haldorsen, T Univ Oslo Dept Behav Sci Med Oslo Norway Norwegian Univ Sci & Technol Dept Psychol N-7034 Trondheim Norway Univ Oslo Dept Med Stat Oslo Norway

All suicides in persons under 20 years in Norway in the time period 1990-1992 (99 males, 30 females) were included in a postmortem case-control study with seven controls for each suicide, focusing on gender differences. Few sex differences between the suicide completers were evident, in spite of the difference in suicide rates (M/F rate ratio = 3.0). Females more often attempted suicide (p = .05), more often wrote farewell notes (p = .03), and used less violent suicide methods (ns). The adjusted risk for suicide related to affective disorders (Female OR = 22,1;Male OR = 24.0, both p = .000) and disruptive disorders (female OR = 14,7, ns;male OR = 5.0, p = .002) differed little, as did the effect of frequent use of alcohol or substances (female OR = 0.4, ns;male OR = 0.4, ns).

关键词：挪威/流行病学冒险性别分布自杀/心理学自杀/统计学和数值数据青少年女(雌)性人类男(雄)性

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Self-harm behavior and no-suicide contracting in psychiatric inpatient settings

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ARCHIVES OF PSYCHIATRIC NURSING 2001年第3期15卷 99-106页

作者： Drew, BL Kent State Univ Coll Nursing Kent OH USA

Although negotiation of no-suicide contracts is common practice, research regarding the outcomes of contracting is inadequate, The purpose of this retrospective review of medical records was to examine how no-suicide contracting affected the likelihood of self-harm behavior in psychiatric inpatient settings. Thirty-one patients (4.8%) engaged in self-harm behaviors representing 2.64% of all patients admitted to both study settings during the 61/2-month period from which data were collected. Approximately half of those patients expressed suicidal intent. Logistic regression analysis suggested that patients with no-suicide contracts and with higher levels of restriction had a significantly higher likelihood of self-harm behavior (OR = 7.43 and 2.47, respectively, p = .005), Consistency of nursing assignment is likely associated with a lower probability of self-harm (OR = .07) but p = .068 when this variable was included in the model, Prevention of self-harm behaviors by the use of no-suicide contracting is not shown. Negotiation of a contract is likely a reflection of staff assessment that the patient was at high risk for suicide. These findings confirm the need for thorough, ongoing assessment of suicidal risk, whether or not a patient has agreed to a no-suicide contract. Copyright (C) 2001 by W,B, Saunders Company.

关键词：医院专科病房住院病人/心理学 Logistic模型谈判/方法护士病人关系护理估计护理评价研究结果评价(卫生保健) 病人参与精神病护理学/方法回顾性研究危险因素自我伤害行为/护理自我伤害行为/预防和控制自我伤害行为/心理学自杀/预防和控制自杀/心理学自杀/统计学和数值数据女(雌)性人类男(雄)性

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Suicide and occupation in Hong Kong

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PERCEPTUAL AND MOTOR SKILLS 2000年第1期91卷 105-106页

作者： Yan, YY Hong Kong Baptist Univ Dept Geog Kowloon Hong Kong Peoples R China

Suicide rates were highest among Service workers and the lowest in Agriculture workers and fisherfolk in Hong Kong.

关键词：年龄因素农业/统计学和数值数据香港/流行病学职业/统计学和数值数据季节自杀/心理学自杀/统计学和数值数据老年人人类

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Suicide among German federal and state police officers

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PSYCHOLOGICAL REPORTS 1999年第1期84卷 157-166页

作者： Schmidtke, A Fricke, S Lester, D Univ Wurzburg Psychiat Klin & Poliklin D-97080 Wurzburg Germany Richard Stockton Coll Pomona NJ 08240 USA

Most American studies report higher police officer suicide rates in comparison to age-matched populations. In the Federal Republic of Germany police organizations are comprised of Federal Customs, 16 state police, and 2 federal police organizations. A sun ey carried out in 1997 yielded higher suicide rates for police officers also in Germany in comparison to rates of the comparable age group (25 per 100,000 vs 20 per 100,000). The most commonly used suicide method was firearms (66-71%). Hypotheses often attribute this high suicidality among police officers to higher work stress than in other professions. Other hypotheses implicate individual variables such as psychiatric illnesses, alcoholism, and interpersonal and marital problems. A transactional model might explain these different views.

关键词：德国警察回顾性研究自杀/心理学自杀/统计学和数值数据青少年成年人女(雌)性人类男(雄)性中年人

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Adverse events reporting-The tip of an iceberg

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Accountability in Research 2001年第3期8卷 197-218页

作者： Shamoo, Adil E. University of Maryland School of Medicine Baltimore MD 21201 108 N. Greene Street United States

NIH data indicate that annually seven million human subjects are enrolled in research sponsored by NIH alone. In addition, there are sixteen federal agencies and numerous departments outside NIH conducting experiments with human subjects. Moreover, the pharmaceutical industry spends S26 billion on research (compared to $16 billion for NIH), thus, the total number of human subjects enrolled in research for both the public and private sectors can be estimated as high as nineteen million* 1 present data on the potential magnitude of adverse events in the United States among human subjects enrolled in research that appear to be unreported and unaccounted for. We obtained data from the Office for Human Research Protections (OHRP) through the Freedom of Information Act for the years 1990 to August 2000 regarding all Institutional Incident Reports (IRPTs) and a list of Compliance Oversight Branch Investigations (COBIs) involving Multiple Project Assurances (MPAs). In the ten years of reporting for nearly seventy million human subjects, there were only 878 IRPTs and 41 investigations. From the incident reports to OHRP, 44% involved adverse events. Those projects investigated for Multiple Project Assurances violations (41 such investigations) showed that 51% were suspended or terminated. The number of deaths reported to OHRP in ten years for the seventy million human subjects is merely eight. The anticipated number of deaths among the general population of seventy million (assuming subject's duration in trials is one month) is 51,000. The number of suicides and attempted suicides alone among the seventy million expected research subjects can be anticipated to be about 5,000. Therefore, the number of expected deaths should have been between 5,000 and 51,000. These numbers and percentages represent minimal numbers since they are not a result of random audits or investigations, but a result of self-reporting or an exogenous complaint. Despite the fact that these are conservativ

关键词：制药工业/经济学联邦政府政府调控坚持准则/统计学和数值数据人类实验/统计学和数值数据法定报告国立卫生研究院(美国) 研究对象科学上不正当行为自杀/统计学和数值数据美国美国食品和药物管理局人类

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Suicide risk assessment: A review of procedures

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Accident and Emergency Nursing 2000年第3期8卷 178-186页

作者： Lyons, Christina Price, Patricia Embling, Sandra Smith, Carol Centre Academic Manager School of Health and Human Sciences Liverpool John Moores University Liverpool L2 2ER 79 Tithebarn Street United Kingdom Gatehouse Assessment Centre Warrington United Kingdom

Suicide risk assessment is an important part of the nurse's role. Suicide screening is an integral component of the assessment process. It should be systematic and follow a prescribed procedure: client self assessment, holistic assessment and diagnosis. The Gatehouse Assessment Centre in Warrington, UK, a predominantly nurse led centre, was opened in 1995, operates 365 days, 9 am till 9 pm, with open referral. The Centre offers psychiatric assessment, short-term treatments or referral on without hospital beds. In line with local and national policy, the Gatehouse team have introduced suicide rating scales as part of their risk screening process. However, the team have encountered problems using their designated scale, adapted from the Suicide Intent Scale, Pierce (1981). The major problem with the use of a rating scale was that, as a one off scoring system, it did not reflect the dynamic nature of suicidal behaviour. Furthermore, it is questionable whether a tool developed for research purposes would be used in the same way in practice. From a clinical perspective, the tool was capable of measurement only and failed to assist a dynamic holistic assessment required by practitioners. It was, therefore, necessary to review and evaluate the risk assessment procedure. In order to address these problems an assessment procedure which is more than a once only 'score' was piloted. The procedure incorporated risk screeners. Rather than rely on a value weighting system, or a positive or negative conclusion, it took account of the continuum of risk which is contingent on a broad range of factors. It took account of the accumulation of risk factors which may be increased or reduced in the light of unfolding events. Details of the new procedure, how it has been incorporated into the assessment process and subsequent management plan, and methodological considerations for further study are detailed. © 2000 Harcourt Publishers Ltd.

关键词：表格和记录管理整体保健普查/方法普查/标准开业护士/标准护理估计/方法护理估计/标准护理评价研究护理记录病人医疗小组/组织和管理试点项目精神病护理学/方法精神病护理学/标准精神病状态评定量表/标准危险性评估危险因素自杀/心理学自杀/统计学和数值数据成年人人类男(雄)性

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Suicide among the young - the size of the problem

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JOURNAL OF ADOLESCENCE 1999年第1期22卷 145-155页

作者： Madge, N Harvey, JG Natl Childrens Bur London EC1V 7QE England

It is widely recognized that official suicide rates conceal the real scale of non-accidental self-injurious fatal behaviour, including among children and young people. There are many reasons for this including the constraints of registration policy and practice, uncertainty about the circumstances surrounding a death, an unwillingness-often for the family's sake-to affix a suicide label on a child, and perhaps the belief that the term "suicide" is not quite accurate. The present study examined all records over a 17-year period from an inner London coroner's office in order to make some quantitative assessment of the extent to which non-accidental self-injurious deaths might be underestimated by suicide returns among those under 20 years. It is suggested on the basis of this examination that the real rate of what might be termed "suicide" among this group may be up to three times the official recorded level. This finding received general confirmation from a smaller-scale comparison in an out of London location. (C) 1999 The Association for Professionals in Services for Adolescents.

关键词：偏倚(流行病学) 死亡原因横断面研究数据收集/统计学和数值数据发病率伦敦/流行病学自杀/预防和控制自杀/统计学和数值数据市区人口/统计学和数值数据青少年成年人儿童女(雌)性人类男(雄)性

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