Wednesday, September 26, 2007

Wednesday, September 12, 2007

Gun Ownership Does Not Correlate with Suicide Rates

This article reviews multi-national comparisons of gun ownership and suicide rates, finding no relationship.

Friday, September 7, 2007

Suicidality Correlates With Quality of Life Rating

This study tested the hypotheses (1) middle aged and older patients with schizophrenia, depressive symptoms and suicidality would exhibit worse quality of life and worse everyday functioning, social skills and medication management relative to those without suicidality; (2) higher levels of suicidality would be significantly associated with worse functioning, worse quality of life and older age.

It showed only quality of life scores predicted suicidality, but not performance skills, social skills, nor medication management skills.

Thursday, September 6, 2007

Suicide Rate Increases for Girls

This sharp increase coincides with the deterrence of anti-depressant use by the totally irresponsible black box warning. I demand the FDA Psychopharmacology Advisory Committee and the FDA Commissioner resign. I demand the two members who voted against the warning resign as well for failing to stop their irresponsible co-members.

Tuesday, September 4, 2007

Survey Shows Black Box Warning Deters 40% of Clinicians

The August, 2007, Neuropsychiatry Reviews, (p. 1, 24) reports on a survey conducted by Tim Petersen. About 40% of psychopharmacology clinicians, treating children and adolescents felt discouraged from prescribing anti-depressants, directly because of the FDA black box warning of 2004 and of 2007. On the other hand, 60% felt anti-depressants helped with suicidality. Although this survey was informal, and unscientific, it still indicates the adverse impact on specialists.

Monday, August 27, 2007

Articles on Suicide

Psychiatry Drug Alerts reviewed three studies, with a combined total of 109,000 patients. Attempts increased prior to treatment, peaking in the month prior to treatment, dropping steeply after the start of treatment, and continuing to decrease as treatment continued. This conclusion contradicts the FDA Psychopharmacology Committee black box warning, and makes it garbage science. The same conclusion resulted from a separate VA study of adults, that SSRI anti-depressants do not increase the risk of suicide. (Psychiatry Drug Alerts 21: 57-58)

Decision making in suicidal patients was tested with a standardized gambling test. Subjects learn to defer immediate rewards to get long-term rewards. Their score correlated with interpersonal difficulties in the affective domain. (J Affect Disord 99:59-62, 2007)

Patients over 50 with major depression had more impulsive suicide attempts with cognition problems, disability, and impaired self-care. They prepared for a suicide more often when older, isolated or living alone. (J Affect Disord 97:123-128, 2007)

Blacks do not have lower rates of suicidality. The lifetime prevalence of attempts was 4.1%, for suicidal ideas, 11.7%. In the first year of ideas, 77% progressed to an attempt. Increased risk associated with a younger cohort, lower educational attainment, living in the Midwest. These rates are those of the general population, and not lower. (JAMA 26:2112-2123, 2006)

Compared to depressed controls, adult patients with depression and a history of child abuse more often attempted suicide, got rated as impulsive and aggressive. Those who attempted suicide (71% v. 43% in the control group), had higher scores for impulsivity and aggression. (Am J Pscyhiat 158:1871-1877, 2001)

Of over 3000 female twins, ages 13 to 19, 4% reported attempting suicide before age 17. About half the attempters and a twelfth of the non-attempters had depression. Other risk factors included childhood physical abuse, social phobia, alcohol dependence, being black, and having conduct disorder. Risk increased 4 to 10 fold if a relative had died of suicide. The identical twin concordance rate was 25%, and 13% for dizygotic twins. Aside from psychopathology association with suicide, a familial link exists. (J Am Acad Child Adol Psychiat 40:1300-1207, 2001)

The highest levels of suicidal ideas take place in bipolar patients during the mixed phase. Age and depth of depression predicted suicide attempts. Anxiety did not. Patients did not make suicide attempts during mania. (J Affect Disord 2007; 97:101-107)

Among depressed patients, 16% reported prior suicide attempts. These were less educated, less likely married, more likely unemployed, with more substance abuse, co-morbidities, and PTSD. They had earlier onsets, increased severity, more episodes, and greater risk of suicidal behavior than the other depressed patients. (J Affect Disord 97:77-84, 2007)

A quarter of elderly depressed patients had suicidality. In half the suicidal patients, suicidality resolved after a month. In a quarter, it emerged late in treatment. About a quarter never experienced suicidality at any time. Suicidal and non-suicidal patients had equal severity of depression. The suicidal group has more anxiety, earlier onsets, more low self-eateem, and partial or no response to treatment. (J Affect Disord 2007; 98:153-161)

Anxiety symptoms associated with suicidal ideation in bipolar patients. It was ruminations, especially, that best linked to suicidal ideation. (J Affect Disord 97: 91-99, 2007)

At risk youth endorsed maladaptive coping strategies, increasingly more often with increasing risk factors. They avoided help seeking behavior. Such thinking requires persuasion during psychotherapy to change coping reactions. (J Am Acad Child Adol Psychiat 43:1124-1133, 2004)

Suicide rates peak in May, are lowest in February. Season represents a risk factor for suicide. Sunspot activity and geomagnetic field change did not. (J Affect Disord 81:133-139, 2004).

Among very depressed patients, these features predicted a higher risk of suicide attempt: a history of suicide attempt, subjective ratings of depression severity, cigarette smoking, aggression or impulsivity. (Am J Psychiat 161:1433-1441, 2004).

Dating Violence Increases the Risk of Suicidal Behavior by Girls by 60%

Girls suffer dating violence at a rate of 11%, and boys at 10%. Such female victims had a rate of suicidality 60% higher. Boys subject to dating violence did not have an increase in rates of suicidal behavior.

Defendants in a suicide malpractice lawsuit might consider a cross-claim against any dating abuser for increasing the risk of suicide of the victim.