The relationship between media reporting of suicide and actual suicide in Australia

This study aimed to determine whether media items about suicide were associated with differential increases in actual suicides. Data were available on 4635 suicide-related items appearing in Australian newspapers and on radio and television news and current affairs shows between March 2000 and February 2001. These data were combined with national data on completed suicides occurring during the same period, by a process that involved identifying the date and geographical reach of the media items and determining the number of suicides occurring in the same location in selected weeks pre- and post-item. Regression analyses were conducted to determine whether the likelihood of an increase in post-item suicides could be explained by particular item characteristics. We found that 39% of media items were followed by an increase in mate suicides, and 31% by an increase in female suicides. Media items were more likely to be associated with increases in both male and female suicides if they occurred in the context of multiple other reports on suicide (versus occurring in isolation), if they were broadcast on television (versus other media), and if they were about completed suicide (versus attempted suicide or suicidal ideation). Different item content appeared to be influential for males and females, with an increase in male suicides being associated with items about an individual's experience of suicide and opinion pieces, and an increase in female suicides being associated with items about mass- or murder-suicide. Item prominence and quality were not differentially associated with increases in male or female suicides. Further research on this topic is required, but in the meantime there is a need to remain vigilant about how suicide news is reported. Mental health professionals and suicide experts should collaborate with media professionals to try to balance 'public interest' against the risk of harm. (c) 2005 Published by Elsevier Ltd.

Psychiatric adverse effects of zonisamide in patients with epilepsy and mental disorder comorbidities

Over the last few years, zonisamide has been proposed as a potentially useful medication for patients with focal seizures, with or without secondary generalization. Since psychiatric adverse effects, including mania, psychosis, and suicidal ideation, have been associated with its use, it was suggested that the presence of antecedent psychiatric disorders is an important factor associated with the discontinuation of zonisamide therapy in patients with epilepsy. We, therefore, set out to assess the tolerability profile of zonisamide in a retrospective chart review of 23 patients with epilepsy and comorbid mental disorders, recruited from two specialist pediatric (n=11) and adult (n=12) neuropsychiatry clinics. All patients had a clinical diagnosis of treatment-refractory epilepsy after extensive neurophysiological and neuroimaging investigations. The vast majority of patients (n=22/23, 95.7%) had tried previous antiepileptic medications, and most adult patients (n=9/11, 81.8%) were on concomitant medication for epilepsy. In the majority of cases, the psychiatric adverse effects of zonisamide were not severe. Four patients (17.4%) discontinued zonisamide because of lack of efficacy, whereas only one patient (4.3%) discontinued it because of the severity of psychiatric adverse effects (major depressive disorder). The low discontinuation rate of zonisamide in a selected population of patients with epilepsy and neuropsychiatric comorbidity suggests that this medication is safe and reasonably well-tolerated for use in patients with treatment-refractory epilepsy. Given the limitations of the present study, including the relatively small sample size, further research is warranted to confirm this finding. © 2013 Elsevier Inc.

‘Everything’s from the inside out with PCOS’:exploring women’s experiences of living with Polycystic Ovary Syndrome (PCOS) and co-morbidities through Skype™ interviews

Polycystic ovary syndrome is an endocrine disorder affecting 1 in 10 women. Women with polycystic ovary syndrome can experience co-morbidities, including depressive symptoms. This research explores the experience of living with polycystic ovary syndrome and co-morbidities. Totally, 10 participants with polycystic ovary syndrome took part in Skype™ interviews and analysed using thematic analysis. Four themes emerged from the data: change (to life plans and changing nature of condition); support (healthcare professionals, education and relationships); co-morbidities (living with other conditions and depression, self-harm and suicidal ideation) and identity (feminine identity and us and them). The findings highlight the need for screening of women with polycystic ovary syndrome for depressive disorders.

The role of suicide risk in the decision for psychiatric hospitalization after a suicide attempt

BACKGROUND: Suicide prevention can be improved by knowing which variables physicians take into account when considering hospitalization or discharge of patients who have attempted suicide. AIMS: To test whether suicide risk is an adequate explanatory variable for predicting admission to a psychiatric unit after a suicide attempt. METHODS: Analyses of 840 clinical records of patients who had attempted suicide (66.3% women) at four public general hospitals in Madrid (Spain). RESULTS: 180 (21.4%) patients were admitted to psychiatric units. Logistic regression analyses showed that explanatory variables predicting admission were: male gender; previous psychiatric hospitalization; psychiatric disorder; not having a substance-related disorder; use of a lethal method; delay until discovery of more than one hour; previous attempts; suicidal ideation; high suicidal planning; and lack of verbalization of adequate criticism of the attempt. CONCLUSIONS: Suicide risk appears to be an adequate explanatory variable for predicting the decision to admit a patient to a psychiatric ward after a suicide attempt, although the introduction of other variables improves the model. These results provide additional information regarding factors involved in everyday medical practice in emergency settings.

Quality of the written information about suicide attempters

INTRODUCTION: The aim of the study was to assess the quality of the clinical records of the patients who are seen in public hospitals in Madrid after a suicide attempt in a blind observation. METHODS: Observational, descriptive cross-sectional study conducted at four general public hospitals in Madrid (Spain). Analyses of the presence of seven indicators of information quality (previous psychiatric treatment, recent suicidal ideation, recent suicide planning behaviour, medical lethality of suicide attempt, previous suicide attempts, attitude towards the attempt, and social or family support) in 993 clinical records of 907 patients (64.5% women), ages ranging from 6 to 92 years (mean 37.1±15), admitted to hospital after a suicide attempt or who committed an attempt whilst in hospital. RESULTS: Of patients who attempted suicide, 94.9% received a psychosocial assessment. All seven indicators were documented in 22.5% of the records, whilst 23.6% recorded four or less than four indicators. Previous suicide attempts and medical lethality of current attempt were the indicators most often missed in the records. The study found no difference between the records of men and women (z=0.296; p=0.767, two tailed Mann-Whitney U test), although clinical records of patients discharged after an emergency unit intervention were more incomplete than the ones from hospitalised patients (z=2.731; p=0.006), and clinical records of repeaters were also more incomplete than the ones from non-repeaters (z=3.511; p<0.001). CONCLUSIONS: Clinical records of patients who have attempted suicide are not complete. The use of semi-structured screening instruments may improve the evaluation of patients who have self- harmed.

Differences in treatment and intervention needs of girls arrested for status versus criminal offenses

The purpose of this research was to explore the differences in factors associated with girls' status and criminal arrests. This study used data from six juvenile justice programs in multiple states, which was derived from the Juvenile Assessment and Intervention System (JAIS). The sample of 908 adolescent girls (ages 13-19) was ethnically and racially diverse (41% African American, 32% white, 12% Hispanic, 11% Native American and 4% Other). A structural equation model (SEM) was analyzed which tested the potential effects of adolescent substance use, truancy, suicidal ideation/attempt, self-harm, peer legal trouble, parental criminal history and parental and non-parental abuse on type of offense (status and criminal) and whether any of these relationships varied as a function of race/ethnicity. ^ Complex relationships emerged regarding both status and more serious criminal arrests. One of the most important findings was that distinct and different patterns of factors were associated with status arrests compared to criminal arrests. For example, truancy and parental abuse were directly associated with status offenses, whereas parental criminal history was directly related to criminal arrests. However, both status and criminal arrests shared common associations, including substance use, which signifies that certain variables are influential regarding both non-criminal and more serious crimes. In addition, significant meditating influences were observed which help to explain some underlying mechanisms involved in girls' arrest patterns. Finally, race/ethnicity moderated a key relationship, which has serious implications for treatment. ^ In conclusion, the present study is an important contribution to research regarding girls' delinquency in that it overcomes limitations in the existing literature in four primary areas: (1) it utilizes a large, multi-state, ethnically and racially diverse sample of justice system-involved girls, (2) it examines numerous co-occurring factors influencing delinquency from multiple domains (family, school, peers, etc.) simultaneously, (3) it formally examines race/ethnicity as a moderator of these multivariate relationships, and (4) it looks at status and criminal arrests independently in order to highlight possible differences in the patterning of risk factors associated with each. These findings have important implications for prevention, treatment and interventions with girls involved in the juvenile justice system.^

Parental and cultural influences on Hispanic college women's verbal intimate partner violence victimization: An examination of within group differences

Prior research has shown that college women in the United States are experiencing significantly high rates of verbal intimate partner violence (IPV); estimates indicate that approximately 20-30% of college women experience verbal IPV victimization (e.g., Hines, 2007; Muñoz-Rivas, Graña, O'Leary, & González, 2009). Verbal IPV is associated with physical consequences, such as chronic pain and migraine headaches, and psychological implications, including anxiety, depression, suicidal ideation, and substance use (Coker et al., 2002). However, few studies have examined verbal IPV in college populations, and none have focused on Hispanic college women who are members of the largest minority population on college campuses today (Pew Research Center, 2013), and experience higher rates of IPV victimization (Ingram, 2007). The current dissertation sought to address these gaps by examining the influence of familial conflict strategies on Hispanic college women's verbal IPV victimization. Further, within group differences were explored, with specific attention paid to the role of acculturation and gender role beliefs. A total of 906 from two Hispanic Serving Institutions (HSI) in the southeastern (N=502) and southwestern (N=404) United States participated in the three part study. Study one examined the influence of parental conflict strategies on Hispanic women's verbal IPV victimization in current romantic relationships. Consistent with previous research, results indicated that parental use of verbal violence influenced verbal IPV victimization in the current romantic relationship. A unidirectional effect of paternal use of verbal aggression towards the participant on maternal verbal aggression towards the participant was also found. Study two examined the influence of parental conflict strategies, acculturation, and gender role beliefs on victimization. Acculturation and gender role beliefs were found to not have an influence on participants' verbal IPV victimization. Study three examined within-group differences using Study two's model. Differences were found between the southeastern and southwestern participants; gender role beliefs increased rates of verbal IPV victimization in the southeastern population. The current dissertation fills a gap in the literature on IPV experiences in Hispanic college populations, the importance of examining verbal IPV trends, and highlights importance differing cultural influences within populations traditionally viewed as homogenous. The implications for future research are discussed.^

Sexualidade e saúde mental: construindo sentidos entre pessoas usuárias de um CAPS

When expressed by mental health services users, sexuality is typically denied by professionals, viewed as another symptom or as if these people are not capable of practicing it. Once Brazilian health professionals haven’t shown lots of investment in this theme, and few are the studies in this field, it is necessary the attention to be focused on researches involving this public. Therefore, the main goal of this study was understand the meanings of sexuality of the mental health services users, which were negotiated in sexuality workshops. The secondary goals were: a) understand the meanings of themes about sexuality brought by users through their experiences of everyday life; b) to evaluate the facilitating experience of the workshops on sexuality at CAPS. Thus, 10 workshops on sexuality were held, with an average of an hour and twenty minutes each, distributed from December 2014 and April 2015. There were 43 participants, 29 women and 14 men. The meetings had the following central themes: sexuality; sexuality and mental health; myths, beliefs and sexual taboos; gender identity; sexual orientation; sexual and reproductive rights; safe sex; and STD/AIDS. The data collection was through audio-recording of these meetings. Later, was made the transcript of the workshops, a careful reading of these transcripts and then its analysis. It was identified categories to analyze the interfaces that permeate the focus of the study. Initially, the categories relating to mental health and sexuality: meanings about sexuality; gender issues; gender and religion; sexual rights, STD/AIDS prevention and attention or denial of sexuality at CAPS. Later, those relating to the workshops facilitating process: challenges in facilitating the workshops; and the perception of the participants. A variety of meanings about sexuality could be noticed in the users’ statements, relating it more with affection and respect than with intercourse. The gender issues that emerged during the workshops were related to marital relationship, sexism, domestic violence, psychological violence and male and female roles in society. Moreover, were also revealed some situations that associated gender differences with religious issues, such as the submission of women and homosexuality. It was also noticed some experiences of the participants involving worrying situations of family violence, suicidal ideation and chemical castration, were often mismanaged or ignored by the service professionals. With regard to the facilitation of the workshops, it was possible to legitimize it as places where users were able to talk openly about the suggested themes and highlight its importance to the study site. Besides, it’s possible to list a few challenges of its facilitation in a mental health service, which was in general positively evaluated by the participants. Thus, the research highlights the need for sexuality theme discussion in mental health services, in order to understand, discuss and inform the users. Also, it’s important to problematize the stigma created in the theme relation with the users, the professionals and the society, working its specificities and avoiding a pathological bias.

Estudo da Ideação Suicida em Adolescentes com Consumo de Álcool

Este estudo exploratório visa abordar a ideação suicida na adolescência e a importância desta etapa que precede a fase adulta, nomeadamente no desenvolvimento psicológico, físico e social com o intuito do sentimento de bem-estar centrado na harmonia, ou seja, na saúde mental. Na adolescência, experienciam-se várias modificações, e as alterações afectivas podem ser vivenciadas com sofrimento extremo e conduzir à ideação suicida. Sendo diversos os factores que podem ser precipitadores, foi dada especial atenção ao consumo de álcool. A amostra de 333 adolescentes da Escola Secundária Dr. Bernardino Machado, pertencentes ao 10º, 11º e 12º ano foi submetida a um questionário constituído por uma recolha de dados sócio-demográficos, o BSI e a escala CAGE. Após a recolha de dados e o seu tratamento estatístico, verificámos que dos 329 estudantes apenas 6 associaram o consumo de bebidas alcoólicas à ideação suicida; o consumo é feito predominantemente na companhia de amigos; a bebida de eleição é a cerveja; existindo 29 jovens que designamos de bebedores de risco. /

Estudo Preliminar de Adaptação e Validação da Escala de Avaliação do Eu Resiliente: resiliência, autodano e ideação suicida em adolescentes

Introdução: Em Portugal, são escassos os instrumentos validados para a população adolescente, que avaliem o importante construto da resiliência. Assim, o principal objetivo deste estudo consistiu na adaptação e validação preliminar da Escala de Avaliação do EU Resiliente (EAER) para adolescentes portugueses. Como segundo objetivo pretendemos, ainda, explorar as associações, na mesma amostra, entre a resiliência, o autodano e a ideação suicida na adolescência. Método: A amostra foi constituída por 226 adolescentes (sexo masculino, n = 139, 61,5%), entre os 12 e os 18 anos, que preencheram um protocolo composto por um questionário sociodemográfico, pela Escala de Avaliação do EU Resiliente (EAER), pelo Questionário de Impulso, Autodano e Ideação Suicida na Adolescência (QIAIS-A) e pela Escala de autoconceito. Resultados: Os resultados obtidos mostraram que a EAER possui boa fidelidade/consistência interna (α = 0,857) e boa estabilidade temporal (r = 0,720). Uma análise de componentes principais mostrou que a EAER apresenta três fatores: fator suporte externo, fator forças pessoais internas e fator estratégias de coping. Encontraram-se correlações negativas entre a resiliência e o autodano e ideação suicida e correlações positivas entre a resiliência e o autoconceito, confirmando-se a validade divergente e convergente da EAER. Verificaram-se níveis elevados de resiliência nos adolescentes da nossa amostra (M = 58,69; DP = 6,67). Na amostra total, 61,5% (n = 139) apresentou ideação suicida e 26,5% (n = 60) apresentou comportamentos de autodano. Conclusão: No seu conjunto, a EAER possui boas características psicométricas, pelo que pode ser considerada uma escala válida e útil e que pode ser usada com segurança na avaliação da resiliência em adolescentes portugueses. Com este estudo alargámos o leque de instrumentos válidos para a medição da resiliência em adolescentes e contribuímos para o avanço da investigação na área da adolescência em Portugal. / Introduction: In Portugal, there are few validated instruments to the adolescent population, to assess the important construct of resilience. Thus, the main objective of this study was the preliminary adaptation and validation of the Escala de Avaliação do EU Resiliente (EAER) to Portuguese adolescents. As a second objective, there is an intention to also explore the associations, on the same sample, between resilience, self-harm and suicidal ideation in adolescence. Method: The sample consisted of 226 adolescents (male, n = 139, 61.5%), between 12 and 18 years, who filled in a protocol consisting of a sociodemographic questionnaire, by the Escala de Avaliação do EU Resiliente (EAER), by the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A) and by the Self-concept Scale. Results: The results showed that the EAER has good fidelity/internal consistency (α = 0.857) and good temporal stability (r = 0.720). A principal component analysis showed that EAER has three factors: external support factor, internal personal strengths factor and coping strategies factor. There were negative correlations between resilience and the self-harm and suicidal ideation and positive correlations between resilience and self-concept, confirming the divergent and convergent validity of EAER. There were high levels of resilience in the adolescents of the sample (M = 58.69, SD = 6.67). In the total sample, 61.5% (n = 139) had suicidal ideation and 26,5% (n = 60) had self-harm behaviors. Conclusion: As a whole, the EAER has good psychometric properties, therefore it can be considered a valid and useful range, and can be safely used in the evaluation of resilience in Portuguese adolescents. With this study we have extended the range of valid instruments for the measurement of resilience in adolescents and contributed to the advance of research in the adolescence area in Portugal.

Estudo dos traços de personalidade e da ideação suicida numa amostra de jovens-adultos

Dissertação de Mestrado, Psicologia Clínica e da Saúde, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2016

Neurobehavioral burden of multiple sclerosis with nanotheranostics

Multiple sclerosis (MS) is a chronic demyelinating neurological disorder affecting people worldwide; women are affected more than men. MS results in serious neurological deficits along with behavioral compromise, the mechanisms of which still remain unclear. Behavioral disturbances such as depression, anxiety, cognitive impairment, psychosis, euphoria, sleep disturbances, and fatigue affect the quality of life in MS patients. Among these, depression and psychosis are more common than any other neurological disorders. In addition, depression is associated with other comorbidities. Although anxiety is often misdiagnosed in MS patients, it can induce suicidal ideation if it coexists with depression. An interrelation between sleep abnormalities and fatigue is also reported among MS patients. In addition, therapeutics for MS is always a challenge because of the presence of the blood-brain barrier, adding to the lack of detailed understanding of the disease pathology. In this review, we tried to summarize various behavioral pathologies and their association with MS, followed by its conventional treatment and nanotheranostics.

A relação entre comportamentos auto lesivos e os comportamentos suicidários e o impacto do funcionamento familiar

Dissertação de Mestrado apresentada no ISPA- Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica

Depresión en pacientes con epilepsia: Revisión sistemática de la literatura

Esta revisión sistemática de la literatura tuvo como objetivo investigar sobre la depresión en personas con epilepsia en la última década (2005-2015), enfocándose en identificar en el paciente con epilepsia: características sociodemográficas, prevalencia de la depresión, tipos de intervención para el manejo de la depresión, factores asociados con la aparición y el mantenimiento de la depresión y por último, identificar las tendencias en investigación en el estudio de la depresión en pacientes con epilepsia. Se revisaron 103 artículos publicados entre 2005 y 2015 en bases de datos especializadas. Los resultados revelaron que la prevalencia de depresión en pacientes con epilepsia es diversa y oscila en un rango amplio entre 3 y 70 %, por otro lado, que las principales características sociodemográficas asociadas a la depresión está el ser mujer, tener un estado civil soltero y tener una edad comprendida entre los 25 y los 45 años. A esto se añade, que los tratamientos conformados por terapia psicológica y fármacos, son la mejor opción para garantizar la eficacia en los resultados del manejo de la depresión en los pacientes con epilepsia. Con respecto a los factores asociados a la aparición de la depresión en pacientes con epilepsia, se identificaron causas tanto neurobiológicas como psicosociales, asimismo los factores principales asociados al mantenimiento fueron una percepción de baja calidad de vida y una baja auto-eficacia. Y finalmente los tipos de investigación más comunes son de tipo aplicado, de carácter descriptivo, transversales y de medición cuantitativa.

Ideación suicida y desesperanza en pacientes con cáncer

El objetivo de la presente investigación fue identificar la relación entre ideación suicida y desesperanza en 160 pacientes con cáncer. La ideación suicida se midió a través de dos ítems de una entrevista semiestructurada, la escala de ideación suicida (ISS), el ítem 9 del inventario de depresión de Beck (BDI-IA). La desesperanza se midió con la escala de desesperanza de Beck (BHS). Los resultados obtenidos indicaron una relación significativa (p=.000) entre ideación suicida y desesperanza; una prevalencia de ideación suicida en los pacientes con cáncer entre 4.4% y 13.8% y de riesgo de suicidio entre 5.6% y 30.6%; y algún grado de desesperanza en 31.9 % de los participantes. De acuerdo con lo anterior, se confirma que existe relación entre la desesperanza y la ideación suicida en pacientes oncológicos adultos. Adicionalmente, que estas variables están presentes en los pacientes y que ameritan atención en la intervención interdisciplinaria.