Motives for Suicide Attempts--the Views of the Patients

This study was designed to investigate the motives patients give for attempting suicide and the associations between these motives and diagnosis, various psychiatric features, suicidal intent and socio-demographic characteristics. The Motives for Parasuicide Questionnaire (MPQ), comprising 14 suggested motives, was presented to 53 patients at a psychiatric ward that specialized in suicide attempters. Escape motives were very common, whereas interpersonal motives were rare. Patients with substance abuse, anxiety, or personality disorders more often chose communicating motives and mentioned higher numbers of motives than those with mood or adjustment disorders. Hopelessness was positively associated with a stated wish to die and with escape motives, and negatively correlated to communicating/unclear motives. Suicidal intent was related to some motives. The psychiatric disorder or mental state seems to be more important than socio-demographic characteristics for the choice of motives. Further studies are required to investigate the associations between psychiatric features and motives, as well as the clinical usefulness of such assessments.     

Predictors of sleep quality in medical students during COVID-19 confinement

ObjectivesWe aimed to assess sleep quality of Tunisian medical students during home confinement due to the COVID-19 pandemic, and to analyze the relationship between sleep quality and sociodemographic, clinical, confinement-related and psychological variables.MethodsA correlational cross-sectional study was conducted from April 11th to May 3rd 2020. Medical students who have been in home confinement and who accepted to participate in an online survey were targeted. Sociodemographic data, clinical variables, and data related to home confinement were collected. Participants also completed Pittsburgh Sleep Quality Index, Depression, Anxiety and Stress Scale and Beck Hopelessness Scale.ResultsResults showed a high prevalence of poor sleepers among medical students (72.5%) with poor subjective sleep quality, increased sleep latency, sleep disturbances and daytime dysfunction. Multiple regression analysis revealed that family history of suicide attempts, tobacco use, perception of home confinement and reduced physical activity during home confinement significantly contributed to poor sleep quality. Among the psychological variables, anxiety and hopelessness significantly contributed to poor sleep quality in medical students during home confinement.ConclusionsResults revealed a high prevalence of poor sleep quality in medical students who have been in home confinement due to the COVID-19 pandemic. Except family history of suicide attempts, factors that significantly contributed to poor sleep quality were modifiable factors. Sleep quality and sleep parameters need to be assessed in this particular population and adequate measures aiming to promote quality of sleep need to be enhanced, given the crucial regenerative, homeostatic and psychological roles of sleep.     

The Level of Hopelessness and Psychological Distress among Abused Women in A Women's Shelter in Turkey

Hopelessness prevents abused women from participating in social life and increases the risk of suicide. The aim of this study was to determine the level of hopelessness and psychological distress among abused women admitted to shelter in a conservative country. The sample included 40 abused women. A questionnaire, Beck Hopelessness Scale and the General Health Questionnaire were used to collect data. Chi-square, the Pearson correlation analysis test, and variance analysis were performed. Half of the women experienced moderate and severe hopelessness. Higher levels of hopelessness were found to be associated with higher psychological distress. Women had problems with decision-making, concentrating on a job, felt unhappiness, and depression. The results of the study would be useful in designing training programs for nurses, social workers and counselors as well as policy makers who assist women facing domestic violence to provide better physiological and psychological care for sheltered women in conservative countries.     

Hiking in Suicidal Patients: Neutral Effects on Markers of Suicidality

Background

Regular physical activity promotes physical and mental health. Psychiatric patients are prone to a sedentary lifestyle, and accumulating evidence has identified physical activity as a supplemental treatment option.

Methods

This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.

Results

All patients participated in the required 2 hikes per week and thus showed a compliance of 100%. Regular hiking led to significant improvement in maximal exercise capacity (hiking period Δ: +18.82 ± 0.99 watt, P < .001; control period: P = .134) and in aerobic capability at 70% of the individual heart rate reserve (hiking period Δ: +8.47 ± 2.22 watt; P = .010; control period: P = .183). Cytokines, associated previously with suicidality (tumor necrosis factor-α, interleukin-6, S100), remained essentially unchanged.

Conclusions

Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.     

Svenska Psykiatriska Föreningen: Svenska psykiatriska föreningens årsmote 26. oktober 1946

Vid Sct. Hans Hospital, afd. E, har clozapin varit föremål för undersökningar, såväl djurexperimentellt som kliniskt, sedan 1971. Erfarenheter från dessa studier sammanfattas av Jes Gerlach i bifogade artikel, som också ger en översikt över litteraturen.     

Hope as experienced in women newly diagnosed with gynaecological cancer

AimThis article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer.MethodFifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24–87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer.ResultsHope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others.ConclusionThe findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.     

Amyotrophic lateral sclerosis and hopelessness: psychosocial factors

The purpose of this study was to investigate the relationship of psychosocial factors to the presence of hopelessness among patients with amyotrophic lateral sclerosis (ALS). Secondary cross-sectional analyses were conducted with data collected from 136 ALS patients. Primary research questions were examined using hierarchical multiple regression procedures. Results showed that health locus of control and purpose in life were significant predictors of hopelessness among ALS patients. Other factors, including socioeconomic and demographic variables, variables measuring length and severity of illness, and additional psychosocial variables (social support satisfaction and degree to which spiritual beliefs help to cope with ALS) were not significant predictors of hopelessness. Results are discussed in light of the benefit to ALS patients of psychosocial interventions in disease management.     

归因方式问卷的初步修订

目的 修订归因方式问卷（ASQ）.方法 对467名大学生进行归因方式问卷（ASQ）和Beck抑郁量表（BDI）的测定.结果 ①修订的归因方式问卷总体信度达到0.8429,各个分量表的信度在0.4～0.9之间.②不同抑郁水平大学生之间归因方式有显著差异,但在正性事件和内外维度上关系不稳定.结论 修订的归因方式问卷的信度和效度指标符合心理测量学的要求,可作为大学生的归因方式测量工具.     

The Role of Perfectionism and Depressive Cognitions in Understanding the Hopelessness Experienced by Adolescent Suicide Attempters

This study examined the relation of two cognitive variables, depressive cognitions and perfectionism, to the hopelessness experienced by adolescent suicide attempters. Adolescent suicide attempters (N = 68) were administered three measures assessing cognitive characteristics commonly associated with adolescent suicidal behavior: the Child and Adolescent Perfectionism Scale (CAPS), the Depressive Experiences Questionnaire for Adolescents (DEQ-A), and the Hopelessness Scale for Children (HSC). Socially prescribed perfectionism on the CAPS and self-criticism on the DEQ-A were both highly correlated with HSC. Regression analyses indicated that perfectionism was significantly related to hopelessness, but this relationship was attenuated after the effects of depressive cognitions on hopelessness were controlled. Self-criticism was the cognitive variable most strongly associated with hopelessness suggesting that it is a more important focus for cognitive interventions in adolescent suicide attempters than perfectionism.