The most disastrous complication for a psychiatric team occurs when the patient commits suicide. The reactions of the personnel involved with the patient are similar to the reactions of the bereaved: denial, guilt and shame, aggression and accusation, relief. By psychological autopsy we mean a structured group meeting where all the factors leading up to the suicide are discussed and the reactions of the personnel ventilated. This is different from psychological debriefing, where the primary aim is to ventilate the reactions of the involved personnel without analyzing what went wrong. The article describes how psychological autopsy has been conducted for more than 15 years at the psychiatric ward in the Central Hospital in Stavanger, Norway.
In 1991, a special health service for doctors was started in Rogaland county. Three years later this service was evaluated via a questionnaire. Two thirds of 109 doctors were very satisfied, and only one was dissatisfied with this health service. The results show a need for both psychosocial and somatic health examinations for doctors.
Comment In: Tidsskr Nor Laegeforen. 1996 Feb 10;116(4):533; author reply 5348644059
Comment In: Tidsskr Nor Laegeforen. 1996 Feb 10;116(4):533; author reply 5348644060
Comment In: Tidsskr Nor Laegeforen. 1996 Mar 10;116(7):8938644105
In order to investigate the need for a health service for doctors a questionnaire was mailed to all doctors in Rogaland county. 84% of the respondents were in favour of such a service. It is necessary not only to provide a general medical examination but to focus also on work-related and psychosocial factors.
We evaluated the feasibility of DBT training, adherence, and retention preparing for a randomized controlled trial of Dialectical Behavior Therapy (DBT) adapted for Norwegian adolescents engaging in self-harming behavior and diagnosed with features of borderline personality disorder. Therapists were intensively trained and evaluated for adherence. Adherence scores, treatment retention, and present and previous self-harm were assessed. Twenty-seven patients were included (mean age 15.7 years), all of them with recent self-harming behaviors and at least 3 features of Borderline Personality Disorder. Therapists were adherent and 21 (78%) patients completed the whole treatment. Three subjects reported self-harm at the end of treatment, and urges to self-harm decreased. At follow up, 7 of 10 subjects reported no self-harm. DBT was found to be well accepted and feasible. Randomized controlled trials are required to test the effectiveness of DBT for adolescents.