Suicide

President Obama announced that he would begin sending letters of condolence to the families of troops who kill themselves in combat zones. He noted that this was a decision that was made after a difficult and exhaustive review of the former policy.

The suicide rate in the US military has steadily climbed over the past 5 to 7 years despite aggressive efforts by the military and the mental health community to counter this trend.

According to the American Foundation for Suicide Prevention, more than 34,000 Americans die by suicide annually. Of these, 10% have never been given a psychiatric diagnosis.

Researchers are developing a scale to measure a clinically identified emotional “trigger state” that puts individuals with suicidal ideation at increased risk of acting on their ideations.

During what season is suicide most common among college students? These questions and more in this week's quiz.

I recently shared a research article on “no-suicide contracts” with a colleague who is very knowledgeable about suicide. That article concluded--as virtually all the previous literature had-that use of suicide prevention contracts (SPC) remains a questionable clinical practice intervention.

Childhood and adolescent bullying-and, recently, cyberbullying-is a major public health problem with potentially devastating consequences. In any prevention effort, students need hope and to learn the skills to end the abuse, as described here.

Major mood disorders have been associated with increased suicidal behavior. This is especially true in patients with a mixed, manic-depressive, or dysphoric-agitated state.

Emerging research suggests that some individuals with particular types of substance use and abuse may be more likely to engage in suicidal behaviors. For example, those who use opiates, cocaine, or sedatives may have a noticeably higher risk of suicide than those who use other drugs.

What goes on in the minds of those who attempt suicide? Here: a psychologist who explores the myths that surround suicide notes "We need to get it in our heads that suicide is not easy, painless, cowardly, selfish, vengeful, self-masterful, nor rash."

The following is a transcript of a podcast by Dr James Lake.

Since the 1980s, there have been growing concerns that chronic cholesterol depletion may actually increase noncardiovascular deaths by suicide and violence-related deaths.

On the morning of September 28, sophomore math major Colton Tooley donned a mask, grabbed an AK-47, and began a shooting spree on the University of Texas campus.

Two recent studies by Harvard psychologists deliver promising data from 2 tests that may help clinicians predict suicidal behavior. The markers in these new tests involve a patient’s attention to suicide-related stimuli and the measure of association with death or suicide.

What Every Psychiatrist Needs to Know to Be Prepared

In addition to their use in the management of epilepsy, anticonvulsants are indicated for management of bipolar disorder, mania, neuralgia, migraine, and neuropathic pain.

When a soldier is killed while in the military service the President writes a condolence letter to the family. However, if a soldier is psychologically injured and then commits suicide, there is no Presidential letter of condolence.

The CASE Approach is built to uncover pieces of a puzzle that enhance the likelihood of an accurate clinical formulation of risk.

Low levels of 3-methoxy-4-hydroxyphenylglycol (MHPG) in patients with major depressive disorder (MDD) or bipolar depression were shown to be associated with increased risk of suicide attempts. Hanga Galfalvy, PhD, assistant professor of clinical neurobiology at Columbia University and the New York State Psychiatric Institute, New York, and her colleagues found that patients with the lowest levels of MHPG at baseline were more likely to commit highly lethal suicidal acts.

Whether treated or untreated, if the outcome of mental illness is suicide, it is a devastating end to a life and it wreaks havoc on family members left behind. Child psychiatrist Nancy Rappaport of Cambridge, Mass, has written a moving memoir of her mother’s suicide that took place during an acrimonious custody battle. Rappaport, at age 4 years, was the youngest of 6 children left behind. She shows great courage as she risks discovering painful information and creating potential ruptures with her father and siblings, some of whom disagree with her decision to write the book.

A few simple steps can enhance your assessment of a patient’s suicide risk-and thereby reduce your own risk for liability if the patient does commit suicide. Phillip J. Resnick, MD, professor of psychiatry and director of forensic psychiatry at Case Western Reserve University in Cleveland, described those measures in a lecture today at the US Psychiatric Congress in Las Vegas.

While violence is often portrayed in the media as related to persons with mental illnesses, there are limited research data to support this idea. This article reviews laws and obligations for mental health professionals.

The FDA is forcing manufacturers of all antiepileptic drugs to include new warnings of possible suicide ideation in the prescribing information and also to prepare a new Medication Guide to be distributed by pharmacies to consumers. In addition, the companies will have to produce a Risk Evaluation and Mitigation Strategy for each drug, which the FDA only requires for drugs with possible adverse effects it considers especially dangerous.

Suicide risk assessment is a core competency that all psychiatrists must have.1 A competent suicide assessment identifies modifiable and treatable protective factors that inform patient treatment and safety management.2 Psychiatrists, unlike other medical specialists, do not often experience patient deaths, except by suicide. Patient suicide is an occupational hazard. A clinical axiom holds that there are 2 kinds of psychiatrists: those who have had patients commit suicide-and those who will.

An increasing youth suicide rate may point toward an emerging public health crisis, necessitating national efforts to develop effective interventions, experts recently warned.

A Blue Ribbon report and a hearing in a House subcommittee raised fresh questions about the sufficiency of the Department of Veterans Affairs (VA) response to suicides among veterans-especially those returning from Iraq and Afghanistan.

In “SSRI Prescribing Rates and Adolescent Suicide: Is the Black Box Hurting or Helping?” (Psychiatric Times, October 2007, page 33) Gibbons and associates primarily use data from their American Journal of Psychiatry article that appeared in September 2007, in a not very veiled attempt to influence doctors and the FDA to roll back the “black-box” warning on the prescription of SSRIs for adolescents.

The Golden Gate Bridge in San Francisco has the regrettable distinction of being the number one spot for suicide in the world. There have been more than 1300 known suicides from the bridge, and in 2007 at least 35 people committed suicide by jumping off the Golden Gate Bridge, more than in any other year.

Suicide is a devastating, tragically frequent outcome for persons with varying psychiatric conditions, including schizophrenia. An estimated 5% to 10% of persons with schizophrenia commit suicide and 20% to 50% attempt suicide during their lifetime.1,2 Patients with schizophrenia have more than an 8-fold increased risk of completing suicide (based on the standardized mortality ratio) than the general population.3

When a suicidal patient in crisis calls the psychiatrist and hears the recorded message, "If you have a 'true' emergency, go to your nearest emergency room or call 911," the patient's risk of suicide may increase.