The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters

BackgroundDuring the process of managing suicide attempters in the emergency department (ED), the importance of hospitalization has been emphasized. Lethality and intent have been suggested as hospitalization determinants of suicide attempters, but their predictive values remain limited in adult and elderly populations.MethodsUsing prospectively collected the ED-based Suicide Registry, data from suicide attempters over 18 years old was retrospectively studied (2010−2020). The enrolled participants were divided into adult (N = 832) and elderly (>65 years, N = 378) groups. Suicide lethality and intent were assessed by the Risk-Rescue Rating Scale (RRRS) and Suicide Intent Scale (SIS), respectively. The moderating effects of age on the relationship between the psychological scales and hospitalization were examined by entering the interaction terms into a multivariable regression model. The predictive ability of each scale for hospitalization was evaluated in terms of performance and goodness-of-fit.ResultsBoth scales' scores in both age groups were significantly higher in hospitalized patients than non-hospitalized patients. Interaction result indicated that only the odds of RRRS for hospitalization significantly differed by age group. Moreover, the predictive performance for hospitalization significantly differed by age group in RRRS but not SIS. In predicting hospitalization, the AUC of the RRRS was significantly higher than that of the SIS in the elderly group but not in the adult group. Comparing the two groups, the RRRS of the elderly group tended to have higher AUC than the adult group, whereas the AUC of the SIS was similar. The RRRS in both groups had a better overall fit compared to the SIS for hospitalization, but its best overall fit and strength with greater power were observed in the elderly group.ConclusionsThe age-by-RRRS interaction is significantly associated with hospitalization, and the RRRS implementation as a hospitalization determinant is more useful and suitable for elderly suicide attempters than for adult suicide attempters in an emergency setting.     

Psychological scales as predictors of emergency department hospitalizations in suicide attempters

Background

The purpose of this study was to evaluate the psychological scales reflecting lethality and intent as predictors of suicide attempter's hospitalization.

PREDICTORS OF SUICIDAL BEHAVIOR IN A SAMPLE OF TURKISH SUICIDE ATTEMPTERS

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent. Suicide lethality was independent of depression severity, hopelessness, and suicidal ideation and intent, suggesting that lethality is likely due to chance.     

Predictors of suicidal behavior in a sample of Turkish suicide attempters

In a Turkish sample, 100 suicide attempters, were compared with 60 healthy controls on measures of hopelessness, depression, and suicidal ideation. Suicide attempters were more depressive, more hopeless, and displayed greater suicidal ideation than healthy controls. Depression severity rather than hopelessness correlated with suicidal intent. Suicide lethality was independent of depression severity, hopelessness, and suicidal ideation and intent, suggesting that lethality is likely due to chance.     

Attitudes toward suicide among mental health professionals

The Suicide Opinion Questionnaire (SOQ) and the Recognition of Suicide Lethality (RSL) scale were administered to 141 mental health professionals representing seven groups: family practice physicians, psychiatrists, psychologists, psychiatric nurses and aides, social workers, crisis line workers, and clergy. The results indicate significant differences among groups on 5 of the 15 SOQ factors, on a clinically derived empathic understanding scale, and on the RSL. Major findings of the study include: (a.) the complexity of attitudes towards suicide; (b) substantial differences between clergy and other mental health professionals; (c) differences between physicians and psychologists on attribution of manipulative motivation to suicide attempts; (d) a relationship between attitudes and personal familiarity with suicide; (t) an ordering of professional groups on the Empathic Understanding Scale reflecting psychological, medical, or religious training; (i) group differences on the recognition of suicide lethality signs; and (g) a relationship between knowledge of lethality and several attitudinal factors.     

Suicide Lethality: A Concept Analysis

Purpose: Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. Methods: A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. Findings: The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Conclusions: Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.     

Veteran Suicide Risk Reduction: A Recommendation for Practice

On August 3, 2016, the United States Department of Veterans Affairs Office of Suicide Prevention published the most comprehensive analysis of Veteran suicide in the nation’s history. After adjusting for differences in age and sex, the risk for suicide was 21% higher in the Veteran population than their civilian peers. Substantial decreases in suicide rates have been achieved after targeted dissemination of the Columbia Suicide Severity Rating Scale, an evidence-based tool that is effective not only as a predictor of suicide risk but also is preventative when appropriately used at every point of care.     

Long-term results and quality of life after parasuicidal multiple blunt trauma

OBJECTIVE: This study evaluates the somatic, socioeconomic, and psychiatric long-term results, as well as the factors for adverse outcome, in a significant subset of patients with severe multiple injuries resulting from attempted suicide. DESIGN: The follow-up study 6.1 +/- 3 (SD) yrs after trauma was based on prospectively documented data of patients with multiple injuries. SETTING: Level I university trauma center in a major German city. MEASUREMENTS AND MAIN RESULTS: Data derived from thorough physical and psychiatric evaluations. The Brief Psychiatric Rating Scale and the Global Assessment of Functioning Scale served to describe psychiatric outcome. PATIENTS: In a series of 539 severely injured patients (Abbreviated Injury Score in two regions > or = 3), 65 (12%) attempted suicides were reported (Injury Severity Score, 40 +/- 15; age, 38 +/- 18 yrs). Twenty-one patients of the study cohort died during the hospital stay, and six subjects died thereafter, none because of suicide. Three patients were lost to follow-up, resulting in 35 individuals eligible for examination. None of the latter had reattempted suicide. Seventeen (48%) had good or satisfactory outcomes reflected by absent or ambulatory psychiatric treatment, employment, normal psychiatric findings (Brief Psychiatric Rating Scale), and good psychosocial ability (Global Assessment of Functioning Scale). For eight patients (24%), the result was indeterminate. The adverse outcomes in ten patients (28%) were mainly influenced by the presence of chronic schizophrenia (n = 4), affective disorder (n = 2), or severe traumatic brain injury (n = 3). CONCLUSIONS: Despite the parasuicidal origin, the long-term results after severe trauma were good or satisfactory in approximately half the cases and without further suicide attempts in any of the patients. Good recovery of the parasuicidal patients in our study is approximately 20% lower than in an unselected group of patients with multiple injuries and may be attributed mainly to the underlying chronic psychiatric disease.     

Attitudes toward suicide among mental health professionals

Abstract

The Suicide Opinion Questionnaire (SOQ) and the Recognition of Suicide Lethality (RSL) scale were administered to 141 mental health professionals representing seven groups: family practice physicians, psychiatrists, psychologists, psychiatric nurses and aides, social workers, crisis line workers, and clergy. The results indicate significant differences among groups on 5 of the 15 SOQ factors, on a clinically derived empathic understanding scale, and on the RSL. Major findings of the study include: (a.) the complexity of attitudes towards suicide; (b) substantial differences between clergy and other mental health professionals; (c) differences between physicians and psychologists on attribution of manipulative motivation to suicide attempts; (d) a relationship between attitudes and personal familiarity with suicide; (t) an ordering of professional groups on the Empathic Understanding Scale reflecting psychological, medical, or religious training; (i) group differences on the recognition of suicide lethality signs; and (g) a relationship between knowledge of lethality and several attitudinal factors.     

Mental turmoil,suicide risk,illness perception,and temperament,and their impact on quality of life in chronic daily headache

To evaluate the relationship among quality of life, temperament, illness perception, and mental turmoil in patients affected by chronic daily headache with concomitant medication overuse headache. Participants were 116 consecutive adult outpatients admitted to the Department of General Medicine of the Sant’Andrea Hospital in Rome, between January 2007 and December 2007 with a diagnosis of chronic daily headache (illness duration >5 years). Patients were administered the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A), the Beck Hopelessness Scale (BHS), the Hamilton Rating Scale for Depression (HAM-D), the Mini-International Neuropsychiatric Interview (MINI), the Revised Illness Perception Questionnaire (IPQ), the Suicide Score Scale (SSS), and the Quality of Life Index (QL-Index). Twenty-eight percent of the patients evidenced moderate to severe depression, and 35% evidenced severe hopelessness. Analyses also indicated that quality of life, temperament, illness perception, and psychological turmoil are associated. However, a hierarchical multivariate regression analysis with quality of life as dependent variable indicated that only a model with mental turmoil variables may fit data; further, only the MINI suicidal intent resulted associated with quality of life (standardized regression coefficient = −0.55; t = −3.06; P < 0.01). Suicide risk may play a central role in affecting the quality of life of patients with chronic headache. The investigation of the interplay of factors that precipitate suicide risk should include assessment of chronic headache and its effects on wellbeing.     

Recognizing and helping the suicidal patient in chiropractic practice

The assessment of a patient's suicide risk is often difficult for the busy practitioner. The present article examined chiropractic interns' and doctors' ability to recognize suicide lethality factors in their patients. On a suicide lethality scale, chiropractic interns and doctors scored significantly lower than a sample of physicians and psychologists and did not score significantly differently than ministers and college students. There was no significant difference between the scores of chiropractic interns and doctors. The article discusses important factors in assessing patient's suicide risk, such as: current mood; suicide plan; and present life circumstances. Suggestions for helping the suicidal patient in co-operation with a psychiatrist or psychologist are presented.     

Rumination,Social Problem Solving and Suicide Intent Among Egyptians With a Recent Suicide Attempt

The more complex influences of social problem-solving abilities and rumination—specifically brooding and reflection—on suicide intent is not well understood. We hypothesized that social problem solving would moderate the association between reflection and suicide intent, and mediate the influence of brooding on suicide intent. A convenience sample (N = 186) of individuals hospitalized for recent suicide attempt was interviewed, assessing suicide intent, social problem solving, brooding, reflection and depression. Brooding and reflection were positively associated with suicide intent. The mediating, but not the moderating, hypothesis was supported. Brooding was not significant (β = 0.15, t = 1.92, p = 0.06) with social problem solving controlled. Interventions to disengage rumination and improve social problem-solving skills are underscored.     

Sense of coherence and suicidality in suicide attempters: a prospective study

The usefulness of the Sense of Coherence (SOC) scale in the nursing setting is well-established, and an association between SOC and suicidality has been suggested. The aim was to test whether low SOC at index attempt is an independent predictor of suicidality at 2-month follow-up and of risk for repeat attempt. The study, which had a prospective cross-sectional design, included patients admitted to hospital after a suicide attempt. They were interviewed by means of Structured Clinical Interview for DSM-IV. Participants (n=155) completed the SOC scale and the Comprehensive Psychopathological Self-rating Scale for Affective Syndromes. Suicidality was rated with the Suicide Assessment Scale. Instruments were employed again at follow-up. Non-fatal/fatal repetition within 3 years was determined by review of hospital records. Low SOC at baseline predicted high suicidality at follow-up. The association remained after adjustment for major depression and affective symptom burden. Repeat attempts were made by 54 persons. Low baseline SOC was associated with repeat attempt, but the association did not remain after adjustment for major depression and symptom burden. Low SOC ratings could be a marker of risk for high suicidality in the aftermath of a suicide attempt. The SOC scale could be incorporated in nursing assessments of suicide attempters.     

数字疼痛量表和描述疼痛量表的相关性研究和改进

目的探讨"长海痛尺"的科学性和可行性.方法研究证明数字疼痛量表(NRS)和描述疼痛量表(VRS)的相关性,并设计"长海痛尺".结果 NRS和VRS之间相关性良好,相关系数r为0.8241.结论 "长海痛尺"的设计具有一定的科学依据,且具有简便、易理解、结果相对准确的特点,可以满足临床一线工作的需要.     

The Research on the Correlation between the Numerical Rating Scale and Verbal Rating Scale and the Improvement on Pain Assessment

Ｔｈｅｐｒｅｃｉｓｅａｓｓｅｓｓｍｅｎｔｏｆｐａｉｎｉｓｏｆｇｒｅａｔｃｌｉｎｉｃａｌｉｍｐｏｒｔａｎｃｅｔｏｍａｋｅｃｌｅａｒｔｈｅｐａｉｎｄｅｇｒｅｅａｎｄｗｈｅｔｈｅｒｔｈｅｉｄｅａｌｅｆｆｅｃｔｓｏｆｐａｉｎｋｉｌｌｉｎｇｉｓａｃｈｉｅｖｅｄ .Ｉｔｉｓａｐｒｅ ｒｅｑｕｉｓｉｔｅｓｔｅｐｔｏｃｈｏｏｓｅａｓｉｍｐｌｅａｎｄｅａｓｉｌｙｏｐｅｒａｔｅｄｔｏｏｌｔｏａｓｓｅｓｓｐａｉｎｐｒｅｃｉｓｅｌｙ .Ｃｌｉｎｉｃａｌｌｙｔｈｅｒｅａｒｅａｌｏｔｏｆｋｉｎｄｓｏｆｒａｔｉｎｇｓｃａｌｅｂｅ…     

The validation of the Italian Perceived Disability Scale (IPDS) in chronic daily headache sufferers

The goals of this study were to assess the validity and usefulness of a new scale and to assess disability in a sample of patients with chronic daily headache. Participants were a convenience sample of 61 adult outpatients admitted to the Department of Medical Sciences of the Sant’Andrea Hospital in Rome, between September 2007 and May 2008. Inclusion criteria were, a diagnosis of chronic daily headache (illness duration >5 years). Patients were administered the Beck Hopelessness Scale (BHS), a specific section of the Mini-International Neuropsychiatric Interview (MINI) assessing suicidal intent, the Gotland Male Depression Scale (GMDS), and a scale devised to measure the degree of disability caused by the headache [Italian Perceived Disability Scale (IPDS)]. Analyses indicated that the IPDS had good internal consistency (Cronbach alpha = 0.93; average inter-item correlation = 0.40), and good convergent validity, with moderate to strong associations with measures assessing emotional distress (BHS, r = 0.47; P < 0.0001; GMDS, r = 0.72; P < 0.001). A single-item, logistic regression analysis indicated that the IPDS is able to predict suicide intent (Wald χ² = 5.04; P < 0.05) in chronic daily headache patients. The IPDS is a brief instrument that is useful for comparisons with other chronic illnesses, and it may be used both for basic research and clinical applications when screening for comorbidity with emotional distress and disorders. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

伴人格障碍自杀未遂者临床特点研究

为探讨伴人格障碍自杀未遂者的临床特点,对108名自杀未遂急诊入院的患者按CCMD-2-R进行人格障碍的诊断,分为伴人格障碍组和不伴人格障碍组,得到社会人口学资料和临床资料并进行自杀意图量表及自杀企图冲动性和致死性的测定,将有关项目作对比分析。结果,有40(37.04％)名自杀未遂者伴发人格障碍。与不伴人格障碍自杀未遂者比较,伴人格障碍自杀未遂者有较多的既往自杀未遂史和精神科治疗史,自杀意图和自杀企图致死性较低,冲动性较高。提示,对伴人格障碍自杀未遂者应给予特别对待和积极治疗。     

探究与大学生抑郁症自杀未遂行为相关的社会心理因素

目的:探究与大学生抑郁障碍患者自杀未遂行为相关的童年创伤、家庭功能及社会支持。方法:招募大学生抑郁障碍患者156例,根据既往是否存在自杀行为分为自杀未遂组(n=78)和非自杀未遂组(n=78)。采用儿童创伤问卷中文版(CTQ)、家庭功能量表(FAD)、社会支持量表(SSRS)对2组进行评估。结果:与非自杀未遂组相比,自杀未遂组的情感虐待(P0.001)、情感忽视(P=0.001)、性虐待(P=0.002)、躯体虐待(P0.001)、躯体忽视(P=0.001)因子评分及总分(P0.001)更高;角色(P=0.039)、情感介入(P=0.023)、家庭总功能(P=0.010)及总分(P=0.018)更高;主观支持(P=0.007)、支持利用率(P=0.005)因子评分及总分(P=0.011)更高。情感虐待、性虐待、支持利用率是导致自杀行为发生的独立危险和保护因素。结论:伴自杀未遂行为的大学生抑郁障碍患者存在更严重的童年创伤、更差的家庭功能以及更少的社会支持。