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目的:探讨重复经颅磁刺激对抑郁症患者自杀的影响。方法:本研究对我院住院并愿意接受研究的89例抑郁症自杀患者进行研究。随机分为两组,研究组40例,对照组49例,两组均给予SSRI类药物治疗,研究组在SSRI类药物治疗的基础上联合重复经颅磁刺激治疗,每周5次,2周为一个疗程,治疗4周。分别于治疗前、治疗2周、治疗4周采用汉密尔顿抑郁量表(HRSD)和自杀意念自评量表(SIOSS)对治疗效果进行评分。结果:两组治疗前HRSD评分及SIOSS评分无显著性差异,治疗后两组的评分均有不同程度的降低,但研究组更显著( P<0.05);研究组在治疗2周后即显效,与对照组比较有显著性差异(χ2=6.059,P<0.05);治疗4周后研究组的有效率明显高于对照组(χ2=18.460,P<0.05)。结论:重复经颅磁刺激能缩短起效时间,改善抑郁症患者的临床症状,主要体现在睡眠、认知障碍、躯体化症状、迟缓及绝望感,并且能降低抑郁症患者的自杀风险。 相似文献
54.
Jung-Won Lee Il-Woong Hwang Jae-Wook Kim Hyung-Jun Moon Ki-Hwan Kim Suyeon Park Hyo-Wook Gil Sae-Yong Hong 《Journal of Korean medical science》2015,30(10):1517-1521
To determine the change in pesticides used during suicide attempts after the 2012 paraquat (PQ) ban, we evaluated the annual number of suicide attempts by pesticide ingestion between 2011 and 2014. We extracted demographic, clinical outcome, and pesticide class data from the medical records of 1,331 patients that attempted suicide by pesticide ingestion. Pesticides were sorted into 5 groups: herbicides, insecticides, fungicides, other pesticides, and combined pesticides. Each group was subdivided into various classes based on publications by the respective Resistance Action Committees. The chi-square test for trends was used to compare the annual incidence of categorical variables. The total number of suicide attempts decreased each year, from 399 in 2011 to 245 in 2014. Simultaneously, PQ ingestion decreased from 253 patients in 2011 to 60 in 2014. The proportion of PQ to pesticides also decreased from 63.4% in 2011 to 24.5% in 2014. Furthermore, the rate of decrease in the proportion of PQ to all herbicide categories increased by calendar year. In conclusion, there is a significant trend in increased annual number of suicides and proportion of suicides using glyphosates and glufosinates versus total herbicides. However, the number of suicide attempts using glyphosate and glufosinate is lower than that using PQ. The ratio of persons completing suicide to those attempting suicide after pesticide ingestion has decreased every year after the PQ ban.
Graphical Abstract
相似文献55.
Self‐injurious implicit attitudes among adolescent suicide attempters versus those engaged in nonsuicidal self‐injury
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56.
Serpil Türkleş Mualla Yılmaz Pınar Soylu 《Collegian (Royal College of Nursing, Australia)》2018,25(4):441-446
Background
It is of the utmost importance to determine the views of nurses about patients with suicidal behavior and who attempt suicide so that they can help such individuals.Aim
The aim of this study was to investigate the feelings, thoughts and experiences of nurses working in a mental health clinic regarding individuals with suicidal behaviors and suicide attempts.Methods
A qualitative study design was employed. Data in this research study were collected through individual in-depth interviews. The study population included 121 nurses working at a Mental Health and Diseases Hospital in Turkey. The study sample consisted of 33 nurses who had been working at the hospital for at least one year, had experience working with patients who attempted suicide, and agreed to participate in the study.Results
The nurses understood the patients; they experienced sadness, worry, anxiety, stress, unrest and fear; they were blamed by the hospital administration when a patient committed suicide; they blamed themselves and doctors for patient suicides; and they had developed proposals to prevent suicide among hospitalized or discharged patients. The nurses also stated that patients committed suicide in the evening or in the early hours of the morning by strangling or hanging themselves or by shocking and unforeseen methods, although the nurses performed the necessary emergency intervention procedures.Conclusion
It is recommended that planned group meetings for nurses be arranged and that follow-up guidelines/protocols for patients with suicidal tendencies who are residing in mental health clinics be prepared by a committee of healthcare professionals. 相似文献57.
Samuel Mullinax Christen E. Chalmers Jesse Brennan Gary M. Vilke Kimberly Nordstrom Michael P. Wilson 《The American journal of emergency medicine》2018,36(10):1779-1783
Background
Suicide screening scales have been advocated for use in the ED setting. However, it is currently unknown whether patients classified as low-risk on these scales can be safely discharged from the emergency department. This study evaluated the utility of three commonly-used suicide screening tools in the emergency department to predict ED disposition, with special interest in discharge among low-risk patients.Methods
This prospective observational study enrolled a convenience sample of patients who answered “yes” to a triage suicidal ideation question in an urban academic emergency department. Patients were administered the weighted modified SADPERSONS Scale, Suicide Assessment Five-step Evaluation and Triage, and Columbia-Suicide Severity Rating Scale. Patients who subsequently received a psychiatric evaluation were included, and the utility of these screening tools to predict disposition was evaluated.Results
276 subjects completed all three suicide screening tools and were included in data analyses. Eighty-two patients (30%) were admitted or transferred. Three patients (1%) died by suicide within one year of enrollment; one was hospitalized at the end of his or her enrollment visit, dying by suicide seven months later and the other two were discharged, dying by suicide nine and ten months later, respectively. The screening tools exhibited modest negative predictive values (range: 0.66–0.73).Conclusion
Three suicide screening tools displayed modest ability to predict the disposition of patients who presented to an emergency department with suicidal ideation. This study supports the current ACEP clinical policy on psychiatric patients which states that screening tools should not be used in isolation to guide disposition decisions of suicidal patients from the ED. 相似文献58.
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. 相似文献
59.
Jack R. Cornelius Ihsan M. Salloum Nancy L. Day Michael E. Thase J. John Mann 《Alcoholism, clinical and experimental research》1996,20(8):1451-1455
The aims of this study were (1) to comprehensively characterize a population of alcoholics with major depression in a psychiatric hospital, (2) to determine the prevalence of suicidal behavior in this sample, and (3) to determine whether quantity of alcohol ingested was associated with level of suicidality. Ratings of drinking, depression, and suicidality were obtained using both self-rated and observer-rated instruments. The prevalence of suicide attempts in the week before hospitalization was remarkably high, approaching 40%, whereas 70% had made a suicide attempt at some point in their lifetime. These suicide attempts were typically impulsive in nature, involving little if any premeditation. Most subjects reported drinking more heavily than usual on the day of their suicide attempt. Recent suicidal behavior was significantly associated with recent very heavy drinking (<70 drinks per week) and with number of drinks per drinking day. Quantity of drinking per drinking day was also significantly higher in those making a recent suicide attempt. However, no association was found between quantity of alcohol consumption and suicidal ideation. These findings suggest that recent heavy alcohol use primarily affects suicidality by increasing the likelihood of acting on suicidal ideation rather than by inducing suicidal ideation. 相似文献
60.
《Research in social & administrative pharmacy》2020,16(3):267-276
BackgroundThe scope and roles of pharmacists worldwide are undergoing dramatic change. Patient-focused care aimed at caring for people that seek medical assistance in dying is among the newest roles. While pharmacists have been involved in medically assisted dying in some international jurisdictions for over two decades, little is known about their actual lived experiences.ObjectiveTo map the literature concerning pharmacy practice in the assisted dying domain to clarify apparent research gaps.MethodsA mapping review was preformed following a systematic search of Medline, CINAHL and IPA to locate academic papers and reports relating to pharmacists’ involvement in assisted dying published between 1990 and 2019. Searches included articles in English, French, and Dutch. References and citations of articles were searched to identify additional articles.ResultsA total of 43 articles were selected, including commentaries (n = 26), reports (n = 2), a scoping literature review (n = 1), and empirical studies (n = 14). Most commentaries centered on pharmacists' roles, ethico-legal and moral challenges, and educational concerns in relation to participation. Of the 14 empirical studies, 12 studies were designed around surveys that focused on pharmacists' attitudes, and opinions concerning assisted dying. Other methodologies included thematic analysis of moral dilemmas, experimental design identifying attitudes to sedation at end of life, and analysis of documents such as guidelines, position statements, and standards of practice. Two studies utilized a qualitative research approach. A significant gap was found with respect to research exploring the actual experience of pharmacists’ practice in medically assisted dying.ConclusionThere is an absence of studies exploring pharmacists’ actual experiences in assisted dying practice. Research involving pharmacists that participate in legally sanctioned assisted dying will facilitate a meaningful understanding of the lived experience of pharmacy practice in this domain. 相似文献