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Treatment received by alcohol-dependent suicide attempters.

https://arctichealth.org/en/permalink/ahliterature202560
Source
Acta Psychiatr Scand. 1999 Mar;99(3):214-9
Publication Type
Article
Date
Mar-1999
Author
K H Suominen
E T Isometsä
M M Henriksson
A I Ostamo
J K Lönnqvist
Author Affiliation
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Source
Acta Psychiatr Scand. 1999 Mar;99(3):214-9
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Deterrents - therapeutic use
Alcoholism - diagnosis - psychology - rehabilitation
Disulfiram - therapeutic use
Female
Finland
Follow-Up Studies
Humans
Male
Medical Records
Psychiatric Status Rating Scales
Psychotherapy - methods
Retrospective Studies
Suicide, Attempted - prevention & control
World Health Organization
Abstract
The purpose of this study was to examine the clinical features of alcohol-dependent suicide attempters and the treatment they received before and after the index attempt. A total of 47 subjects with current DSM-III-R alcohol dependence were identified from a systematic sample of 114 suicide attempters in Helsinki. All of them were comprehensively interviewed after the attempt, and the treatment they had received was established from psychiatric and other health-care records and follow-up interviews. Most had a history of psychiatric (83%) or substance abuse (83%) treatment. During the final month before the attempt, half of the subjects (51%) had been treated by health care services; 11% had received disulfiram-treatment and 6% had received psychotherapy. Subjects complied with recommended aftercare more often when they had been actively referred. After 1 month, 64% were being treated by health care services. However, only 14% were receiving disulfiram-treatment and 9% were receiving psychotherapy. These findings suggest that the quality and activity of treatment offered to suicide attempters with alcohol dependence should be improved.
PubMed ID
10100916 View in PubMed
Less detail
Source
Am J Psychiatry. 1994 Apr;151(4):530-6
Publication Type
Article
Date
Apr-1994
Author
E T Isometsä
M M Henriksson
H M Aro
M E Heikkinen
K I Kuoppasalmi
J K Lönnqvist
Author Affiliation
National Public Health Institute, Department of Mental Health, Helsinki, Finland.
Source
Am J Psychiatry. 1994 Apr;151(4):530-6
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Antidepressive Agents - administration & dosage
Comorbidity
Depressive Disorder - epidemiology - psychology - therapy
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Psychotherapy
Sampling Studies
Sex Factors
Suicide - prevention & control - statistics & numerical data
Treatment Outcome
Violence
Abstract
The purpose of this study was to examine a sample representing all suicide victims with current DSM-III-R major depression in Finland within 1 year in aspects relevant to suicide prevention, including comorbidity, clinical history, current treatment, suicide methods, and communication of suicide intent.
Using the psychological autopsy method, the authors examined all 71 suicide victims with current unipolar DSM-III-R major depression, taken from a random sample of 229 subjects representing 16.4% of all suicide victims in Finland in 1 year.
The majority (85%) were complicated cases with comorbid diagnoses, and comorbidity varied according to the subjects' sex and age. Three-quarters had a history of psychiatric treatment, but only 45% were receiving psychiatric treatment at the time of death. Most suicide victims had received no treatment for depression. Only 3% had received antidepressants in adequate doses, 7% weekly psychotherapy, and 3% ECT. None of the 24 psychotic subjects had received adequate psychopharmacological treatment. Few (8%) had used an antidepressant overdose as a suicide method. Men had received less treatment for depression and had more commonly used violent suicide methods.
Although about half of the suicide victims with major depression were receiving psychiatric care at the time of death, few were receiving adequate treatment for depression. There were significant sex differences in current and previous treatment and suicide methods. For suicide prevention in major depression, it would seem crucial to improve treatment and follow-up, for males with major depression, in particular.
PubMed ID
8147450 View in PubMed
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Inadequate treatment for major depression both before and after attempted suicide.

https://arctichealth.org/en/permalink/ahliterature203720
Source
Am J Psychiatry. 1998 Dec;155(12):1778-80
Publication Type
Article
Date
Dec-1998
Author
K H Suominen
E T Isometsä
M M Henriksson
A I Ostamo
J K Lönnqvist
Author Affiliation
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Source
Am J Psychiatry. 1998 Dec;155(12):1778-80
Date
Dec-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aftercare
Ambulatory Care
Antidepressive Agents - therapeutic use
Attitude to Health
Comorbidity
Depressive Disorder - diagnosis - epidemiology - therapy
Drug Administration Schedule
Female
Finland - epidemiology
Follow-Up Studies
Hospitalization
Humans
Likelihood Functions
Male
Middle Aged
Patient compliance
Psychotherapy
Quality of Health Care - standards
Suicide, Attempted - statistics & numerical data
Treatment Failure
Abstract
The authors' goal was to investigate the treatment received by suicide attempters with major depression before and after the index attempt.
Forty-three patients with current unipolar DSM-III-R major depression were identified in a diagnostic study from a systematic sample of suicide attempters in Helsinki. All were comprehensively interviewed and investigated after the attempt, and their treatment was ascertained from psychiatric and other health care records and follow-up interviews.
During the month just before the suicide attempt, seven (16%) of the patients had received antidepressants in adequate doses, seven had received weekly psychotherapy, and none had received ECT. Although almost all of the patients complied with the recommended aftercare following the suicide attempt, after 1 month only seven (17%) were receiving antidepressants in adequate doses, nine (22%) were receiving weekly psychotherapy, and none had been given ECT.
It seems that few suicide attempters with major depression receive adequate treatment for depression before the suicide attempt and that, despite their well-known high risk for suicide, the treatment situation is not necessarily any better after the attempt. These findings suggest that the recognition of depression and the quality of treatment received for major depression among suicide attempters should be investigated and improved to prevent suicide.
PubMed ID
9842794 View in PubMed
Less detail