Tag Archives: Suicide

Nationwide Children’s Hospital study: Suicide attempts by self-poisoning have more than doubled in teens, young adults

5 May

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes; it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Science Daily reported in Suicide attempt a stronger predictor of completed suicide than previously thought:

While a prior history of suicide attempt is one of the strongest predictors of completed suicide, a Mayo Clinic study finds it is more lethal than previously known.
Researchers find that suicide risk was nearly 60 percent higher than previously reported when based on a population-based cohort focusing on individuals making first lifetime attempts and including those whose first attempts were fatal. This risk was dramatically higher for attempts using firearms. The population sample was identified through the Rochester Epidemiology Project.
“We hoped to address the shortcomings of earlier studies by including two groups previously overlooked by other studies,” says J. Michael Bostwick, M.D., a psychiatrist on Mayo Clinic’s Rochester campus and the lead author of the study published in the American Journal of Psychiatry. “Our study enrolled individuals whose first-ever suicide attempt presented to medical attention. Not only did we include those who survived this initial attempt, but we also included those who died on their first attempt and ended up on the coroner’s slab rather than in the emergency room. These are large groups that have been routinely ignored in calculation of risk.” Since suicide is one of the 10 most common causes of death in the U.S., it is a major public health concern. The study found that nearly 60 percent of people who attempted suicide died on their first attempt…. https://www.sciencedaily.com/releases/2016/09/160912161259.h

Here’s today’s COMMENT FROM AN OLD FART: Reputation takes a long time to burnish and nurture. It can be destroyed by a smear or an ill-thought-out act in a nanosecond.

“The way to gain a good reputation is to endeavor to be what you desire to appear.”
Socrates
“Your reputation is in the hands of others. That’s what the reputation is. You can’t control that. The only thing you can control is your character.”
Wayne W. Dyer
In an attempt to control online reputation, many schools are now helping their students clean their online presentation. Why? Because people like to gossip and most of us have been young and stupid or old and ill-advised.
“Great minds discuss ideas. Average minds discuss events. Small minds discuss people.”
Eleanor Roosevelt
“Isn’t it kind of silly to think that tearing someone else down builds you up?”
Sean Covey, The 7 Habits Of Highly Effective Teens

A study from Nationwide Children’s Hospital indicated that the sadness of many young people is often expressed in self-poisoning attempts.

Science Daily reported in Suicide attempts by self-poisoning have more than doubled in teens, young adults:

A new study from Nationwide Children’s Hospital and the Central Ohio Poison Center found rates of suicide attempts by self-poisoning among adolescents have more than doubled in the last decade in the U.S., and more than tripled for girls and young women.

The study, published online today in the Journal of Pediatrics, evaluated the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-18. In the 19-year time period of the study, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers. More than 71% (1.1 million) of those were female.
“The severity of outcomes in adolescents has also increased, especially in 10- to 15-year-olds,” said Henry Spiller, MS, D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, and co-author of the study. “In youth overall, from 2010-2018 there was a 141% increase in attempts by self-poisoning reported to U.S. poison centers, which is concerning.”
Previous research has shown that suicide is the second leading cause of death among young people aged 10 to 24 years, and that while males die by suicide more frequently than females, females attempt suicide more than males. Self-poisoning is the most common way that someone attempts suicide and third most common method of suicide in adolescents, with higher rates in females.
“Suicide in children under 12 years of age is still rare, but suicidal thoughts and attempts in this younger age group do occur, as these data show,” said John Ackerman, PhD, clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s Hospital, and co-author of the study. “While certainly unsettling, it’s important that parents and individuals who care for youth don’t panic at these findings, but rather equip themselves with the tools to start important conversations and engage in prevention strategies, such as safe storage of medications and reducing access to lethal means. There are many resources and crisis supports available around the clock to aid in the prevention of suicide, and suicide prevention needs to start early.”
According to the Big Lots Behavioral Health experts at Nationwide Children’s, parents should check in regularly with their children, ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed…. https://www.sciencedaily.com/releases/2019/05/190502075817.htm

Citation:

Suicide attempts by self-poisoning have more than doubled in teens, young adults
Date: May 2, 2019
Source: Nationwide Children’s Hospital
Summary:
A new study found rates of suicide attempts by self-poisoning among adolescents have more than doubled in the last decade in the United States, and more than tripled for girls and young women.
Journal Reference:
Henry A. Spiller, John P. Ackerman, Natalie E. Spiller, Marcel J. Casavant. Sex- and Age-specific Increases in Suicide Attempts by Self-Poisoning in the United States among Youth and Young Adults from 2000 to 2018. The Journal of Pediatrics, 2019; DOI: 10.1016/j.jpeds.2019.02.045

Here is the press release from Nationwide Children’s Hospital:

Suicide Attempts by Self-Poisoning Have More Than Doubled in Teens, Young Adults
May 1, 2019
(COLUMBUS, Ohio) – A new study from Nationwide Children’s Hospital and the Central Ohio Poison Center found rates of suicide attempts by self-poisoning among adolescents have more than doubled in the last decade in the U.S., and more than tripled for girls and young women.
The study, published online today in The Journal of Pediatrics, evaluated the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-18. In the 19-year time period of the study, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers. More than 71% (1.1 million) of those were female.
“The severity of outcomes in adolescents has also increased, especially in 10- to 15-year-olds,” said Henry Spiller, MS, D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, and co-author of the study. “In youth overall, from 2010-2018 there was a 141% increase in attempts by self-poisoning reported to U.S. poison centers, which is concerning.”
Previous research has shown that suicide is the second leading cause of death among young people aged 10 to 24 years, and that while males die by suicide more frequently than females, females attempt suicide more than males. Self-poisoning is the most common way that someone attempts suicide and third most common method of suicide in adolescents, with higher rates in females.
“Suicide in children under 12 years of age is still rare, but suicidal thoughts and attempts in this younger age group do occur, as these data show,” said John Ackerman, PhD, clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s Hospital, and co-author of the study. “While certainly unsettling, it’s important that parents and individuals who care for youth don’t panic at these findings, but rather equip themselves with the tools to start important conversations and engage in prevention strategies, such as safe storage of medications and reducing access to lethal means. There are many resources and crisis supports available around the clock to aid in the prevention of suicide, and suicide prevention needs to start early.”
According to the Big Lots Behavioral Health experts at Nationwide Children’s, parents should check in regularly with their children, ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed.
“There is no need to wait until there is a major crisis to talk about a plan to manage emotional distress. Actually, a good time to talk directly about suicide or mental health is when things are going well,” said Ackerman, whose suicide prevention team provides comprehensive programming to more than 120 central and southeast Ohio schools and delivers suicide prevention training to community organizations that serve youth. “A helpful starting point for any parent to increase the dialogue is OnOurSleeves.org, which has resources about beginning this important conversation as a family. The American Association of Suicidology and American Foundation for Suicide Prevention also have many resources.”
Data for this study were collected by the National Poison Data System (NPDS) from January 2000 to November 2018.
If you or your child need immediate help due to having suicidal thoughts, go to your local emergency room immediately, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or you can reach the Crisis Text Line by texting “START” to 741-741. If you believe an overdose has occurred, call the national Poison Help hotline 1-800-222-1222.
About On Our Sleeves
Because kids don’t wear their thoughts on their sleeves, we don’t know what they might be going through. That’s why Nationwide Children’s Hospital launched On Our Sleeves to build a community of support for children living with mental illness through advocacy, education and fundraising for much-needed research. For more information about children’s mental health and to help break the silence and stigma around mental illness, visit OnOurSleeves.org.
About The Central Ohio Poison Center
The Central Ohio Poison Center provides state-of-the-art poison prevention, assessment and treatment to residents in 64 of Ohio’s 88 counties. The center services are available to the public, medical professionals, industry, and human service agencies. The Poison Center handles more than 42,000 poison exposure calls annually, and confidential, free emergency poisoning treatment advice is available 24/7. To learn more about the Poison Center, visit http://www.bepoisonsmart.org.

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention

Resources:

Suicide Prevention
http://www.cdc.gov/violenceprevention/pub/youth_suicide.html

Teen Suicide Overview
http://www.teensuicidestatistics.com/

Teen’s Health’s Suicide
http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx

Suicide Prevention Resource Center
http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression
http://helpguide.org/mental/depression_teen.htm

Jared Story.Com
http://www.jaredstory.com/teen_epidemic.html

CNN Report about suicide http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

A\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

On Our Sleeves                                                        https://www.nationwidechildrens.org/giving/on-our-sleeves/for-professionals

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Mayo Clinic study: Suicide attempt a stronger predictor of completed suicide than previously thought

24 Sep

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes; it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Science Daily reported in Suicide attempt a stronger predictor of completed suicide than previously thought:

While a prior history of suicide attempt is one of the strongest predictors of completed suicide, a Mayo Clinic study finds it is more lethal than previously known.

Researchers find that suicide risk was nearly 60 percent higher than previously reported when based on a population-based cohort focusing on individuals making first lifetime attempts and including those whose first attempts were fatal. This risk was dramatically higher for attempts using firearms. The population sample was identified through the Rochester Epidemiology Project.

“We hoped to address the shortcomings of earlier studies by including two groups previously overlooked by other studies,” says J. Michael Bostwick, M.D., a psychiatrist on Mayo Clinic’s Rochester campus and the lead author of the study published in the American Journal of Psychiatry. “Our study enrolled individuals whose first-ever suicide attempt presented to medical attention. Not only did we include those who survived this initial attempt, but we also included those who died on their first attempt and ended up on the coroner’s slab rather than in the emergency room. These are large groups that have been routinely ignored in calculation of risk.” Since suicide is one of the 10 most common causes of death in the U.S., it is a major public health concern. The study found that nearly 60 percent of people who attempted suicide died on their first attempt….                                                                                                                                https://www.sciencedaily.com/releases/2016/09/160912161259.htm

Citation:

Suicide attempt a stronger predictor of completed suicide than previously thought

Date:         September 12, 2016

Source:     Mayo Clinic

Summary:

While a prior history of suicide attempt is one of the strongest predictors of completed suicide, a new study finds it is more lethal than previously known.

Journal Reference:

  1. J. Michael Bostwick, Chaitanya Pabbati, Jennifer R. Geske, Alastair J. McKean. Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. American Journal of Psychiatry, 2016; appi.ajp.2016.1 DOI: 10.1176/appi.ajp.2016.15070854

Here is the press release from the Mayo Clinic:

  • By Duska Anastasijevic

Suicide attempt a stronger predictor of completed suicide than previously thought

September 12, 2016

ROCHESTER, Minn. — While a prior history of suicide attempt is one of the strongest predictors of completed suicide, a Mayo Clinic study finds it is more lethal than previously known.

Researchers find that suicide risk was nearly 60 percent higher than previously reported when based on a population-based cohort focusing on individuals making first lifetime attempts and including those whose first attempts were fatal. This risk was dramatically higher for attempts using firearms. The population sample was identified through the Rochester Epidemiology Project.

“We hoped to address the shortcomings of earlier studies by including two groups previously overlooked by other studies,” says J. Michael Bostwick, M.D., a psychiatrist on Mayo Clinic’s Rochester campus and the lead author of the study published in the American Journal of Psychiatry. “Our study enrolled individuals whose first-ever suicide attempt presented to medical attention. Not only did we include those who survived this initial attempt, but we also included those who died on their first attempt and ended up on the coroner’s slab rather than in the emergency room. These are large groups that have been routinely ignored in calculation of risk.”

Since suicide is one of the 10 most common causes of death in the U.S., it is a major public health concern. The study found that nearly 60 percent of people who attempted suicide died on their first attempt.

“Almost no other study in the literature includes individuals who die on that first attempt,” Dr. Bostwick adds. “A large part of the reason that such a high proportion of the total suicides occurred on first attempt can be attributed to firearm usage. The results show that it is a 140 time more likely for firearms to cause suicide, compared to all other methods. That means nearly three-fourths of all deaths at first suicide attempt were caused by using firearms. This shows that guns are, unfortunately, but not surprisingly, remarkably effective.”

The study also revealed that the male-female ratio was higher (1.7-to-1) among those making their attempts than what other studies previously purported. Older age in men also is associated with higher suicide risk. Nearly one-third of men over 65 in the study killed themselves.

MEDIA CONTACT: Duska Anastasijevic, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

The Rochester Epidemiology Project diagnostic index was searched electronically to identify 1,490 Olmsted County residents whose first suicide attempt came to medical attention between Jan. 1, 1986, and Dec. 31, 2007. The study included 555 males and 935 females followed for three to 25 years.

While the study confirmed previous findings that the risk decreased in survivors given a follow-up psychiatry appointment, the vast majority of survivors, irrespective of gender, killed themselves within a year after the index attempt. This underscores how important it is that survivors have psychiatric follow-up scheduled after the first attempt and how the first year following a suicide attempt is a critical window for a repeat fatal attempt.

Other authors include: Alastair J. McKean, M.D. and Jennifer R. Geske, M.S., of Mayo Clinic, and Chaitanya Pabbati, M.D., Department of Psychiatry, University of California, San Diego;

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or http://newsnetwork.mayoclinic.org/.

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention

Resources:

Suicide Prevention
http://www.cdc.gov/violenceprevention/pub/youth_suicide.html

Teen Suicide Overview
http://www.teensuicidestatistics.com/

Teen’s Health’s Suicide
http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx

Suicide Prevention Resource Center
http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression
http://helpguide.org/mental/depression_teen.htm

Jared Story.Com
http://www.jaredstory.com/teen_epidemic.html

CNN Report about suicide                                                                                                     http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

A\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

About.Com’s Depression In Young Children                                                                http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children                                          http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children                                                                http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

 

European College of Neuropsychopharmacology study: How to prevent suicide?

31 Aug

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Science Daily reported in How can we prevent suicide? Major study shows risk factors associated with depression:

A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death in men under 35) see notes, below. Effective measures of suicide prevention are urgently needed.

The BRIDGE-II-MIX study is a major international study looking at depression and suicide. The researchers evaluated 2811 patients suffering from depression, of whom 628 had already attempted suicide. Each patient was interviewed by a psychiatrist as if it were a standard evaluation of a mentally-ill patient. The parameters studied included previous suicide attempts, family history, current and previous treatment, patients’ clinical presentation, how they scored on the standard Global Assessment of Functioning scale, and other parameters. The study looked especially at the characteristics and behaviours of those who had attempted suicide, and compared these to depressed patients who had not attempted suicide. They found that certain patterns recur before suicide attempts.

According to author Dr. Dina Popovic (Barcelona):
‘We found that “depressive mixed states” often preceded suicide attempts. A depressive mixed state is where a patient is depressed, but also has symptoms of “excitation,” or mania. We found this significantly more in patients who had previously attempted suicide, than those who had not. In fact 40% of all the depressed patients who attempted suicide had a “mixed episode” rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide.
We also found that the standard DSM criteria identified 12% of patients at showing mixed states, whereas our methods showed 40% of at-risk patients. This means that the standard methods are missing a lot of patients at risk of suicide.”

In a second analysis of the figures, they found that if a depressed patient presents any of the following symptoms:

• risky behaviour (e.g. reckless driving, promiscuous behaviour)
• psychomotor agitation (pacing around a room, wringing one’s hands, pulling off clothing and putting it back on and other similar actions)
• impulsivity (acting on a whim, displaying behaviour characterized by little or no forethought, reflection, or consideration of the consequences),
then their risk of attempting suicide is at least 50% higher.
http://www.sciencedaily.com/releases/2015/08/150830152601.htm

Citation:

How can we prevent suicide? Major study shows risk factors associated with depression
Date: August 30, 2015

Source: European College of Neuropsychopharmacology

Summary:

A major multi-national study of suicides has identified the behavior patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

• Abstract

Send to:
J Clin Psychiatry. 2015 Mar;76(3):e351-8. doi: 10.4088/JCP.14m09092.
Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study.
Perugi G1, Angst J, Azorin JM, Bowden CL, Mosolov S, Reis J, Vieta E, Young AH; BRIDGE-II-Mix Study Group.
Author information

Abstract

OBJECTIVE:

To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity.

METHOD:

This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression.

RESULTS:

Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode > 1 month, atypical features, early onset, history of antidepressant-induced mania/hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder.

CONCLUSIONS:

Depressive mixed state, defined as the presence of 3 or more manic/hypomanic features, was present in around one-third of patients experiencing an MDE. The valid symptom, illness course and family history RBDC criteria we assessed identified 4 times more MDE patients as having mixed features and yielded statistically more robust associations with several illness characteristics of bipolar disorder than did DSM-5 criteria.
© Copyright 2015 Physicians Postgraduate Press, Inc.
Comment in
• “Mixed” depression: drawbacks of DSM-5 (and other) polythetic diagnostic criteria. [J Clin Psychiatry. 2015]
• Mixed depression: a farewell to differential diagnosis? [J Clin Psychiatry. 2015]
PMID:
25830457
[PubMed – indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/25830457

Here is the press release from the European College of Neuropsychopharmacology:

Public Release: 29-Aug-2015 How can we prevent suicide? Major study shows risk factors associated with depression

European College of Neuropsychopharmacology

A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death in men under 35) see notes, below. Effective measures of suicide prevention are urgently needed.

The BRIDGE-II-MIX study is a major international study looking at depression and suicide. The researchers evaluated 2811 patients suffering from depression, of whom 628 had already attempted suicide. Each patient was interviewed by a psychiatrist as if it were a standard evaluation of a mentally-ill patient. The parameters studied included previous suicide attempts, family history, current and previous treatment, patients’ clinical presentation, how they scored on the standard Global Assessment of Functioning scale, and other parameters. The study looked especially at the characteristics and behaviours of those who had attempted suicide, and compared these to depressed patients who had not attempted suicide. They found that certain patterns recur before suicide attempts.

According to author Dr. Dina Popovic (Barcelona):
‘We found that “depressive mixed states” often preceded suicide attempts. A depressive mixed state is where a patient is depressed, but also has symptoms of “excitation”, or mania. We found this significantly more in patients who had previously attempted suicide, than those who had not. In fact 40% of all the depressed patients who attempted suicide had a “mixed episode” rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide.

We also found that the standard DSM criteria identified 12% of patients at showing mixed states, whereas our methods showed 40% of at-risk patients. This means that the standard methods are missing a lot of patients at risk of suicide”.

In a second analysis of the figures, they found that if a depressed patient presents any of the following symptoms:

• risky behaviour (e.g. reckless driving, promiscuous behaviour)
• psychomotor agitation (pacing around a room, wringing one’s hands, pulling off clothing and putting it back on and other similar actions)
• impulsivity (acting on a whim, displaying behaviour characterized by little or no forethought, reflection, or consideration of the consequences),
then their risk of attempting suicide is at least 50% higher.
Dr Popovic continued:

“In our opinion, assessing these symptoms in every depressed patient we see is extremely important, and has immense therapeutical implications. Most of these symptoms will not be spontaneously referred by the patient, the clinician needs to inquire directly, and many clinicians may not be aware of the importance of looking at these symptoms before deciding to treat depressed patients.

This is an important message for all clinicians, from the GPs who see depressed patients and may not pay enough attention to these symptoms, which are not always reported spontaneously by the patients, through to secondary and tertiary level clinicians. In highly specialized tertiary centres, clinicians working with bipolar patients are usually more aware of this, but that practice needs to extent to all levels.

The strength of this study is that it’s not a clinical trial, with ideal patients – it’s a big study, from the real world”.
Commenting ECNP President, Professor Guy Goodwin (Oxford) said:

The recognition of increased activation in the context of a severe depression is an important practical challenge. While many psychiatrists recognize that this constitutes an additional risk for suicide, and would welcome better scales for its identification, the question of treatment remains challenging. We need more research to guide us on best practice. http://www.eurekalert.org/pub_releases/2015-08/econ-hcw082615.php

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention
Resources:

Suicide Prevention
http://www.cdc.gov/violenceprevention/pub/youth_suicide.html

Teen Suicide Overview
http://www.teensuicidestatistics.com/

Teen’s Health’s Suicide
http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx

Suicide Prevention Resource Center
http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression
http://helpguide.org/mental/depression_teen.htm

Jared Story.Com
http://www.jaredstory.com/teen_epidemic.html

CNN Report about suicide                                                                                                                                    http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

About.Com’s Depression In Young Children                                                                                            http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children                                                                                          http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children                                                                                                             http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

New Jersey bill to require teachers get more suicide prevention training

25 Jan

The New Jersey legislature wants to give teachers more training in suicide prevention. According to the National Conference of State Legislatures (NCSL):

  • 19.3 percent of high school students have seriously considered killing themselves.

  • 14.5 percent of high school students made actual plans for committing suicide,

  • 900,000 youth planned their suicides during an episode of major depression.

While suicide does not seem terribly common, it is nevertheless a major cause of death. The CDC reports that it is the third leading cause of death for youth ages 15 to 24. The only two things that cause more death among teenagers are accidents (usually in the car) and homicide. And even younger children do not escape. Suicide is the fourth leading cause of death for young people between the ages of 10 and 14.

Gender differences in teen suicide

Teen suicide statistics show differences in the ways boys and girls handle suicide. While girls think about attempted suicide about twice as much as boys, boys are actually four times more likely than girls to actually die by killing themselves….                                   http://www.teensuicidestatistics.com/statistics-facts.html

The Centers for Disease Control list some risk factors for teen suicide:

Several factors can put a young person at risk for suicide. However, having these risk factors does not always mean that suicide will occur.

Risk factors:

  • History of previous suicide attempts

  • Family history of suicide

  • History of depression or other mental illness

  • Alcohol or drug abuse

  • Stressful life event or loss

  • Easy access to lethal methods

  • Exposure to the suicidal behavior of others

  • Incarceration                                                                                                                                                                    http://www.cdc.gov/violenceprevention/pub/youth_suicide.html

The goal of a proposed bill in New Jersey is early identification and intervention for children at risk of suicide.

Michael Catalini of Associated Press reported in Teachers would get more training on suicide under bill:

Public school teachers would undergo more suicide prevention education under a proposal from a bipartisan group of New Jersey lawmakers.

An Assembly committee approved the measure late last year while Republican state Sen. Diane Allen introduced a similar bill in the Senate this month.

The bill requires public school teachers and staff to receive two hours of suicide prevention training from a licensed health care professional every year, up from the current requirement of two hours over five years.

Democratic Assemblywoman Pamela Lampitt said she and her colleagues are pursuing the change now because of the increased use of technology by students and the rise of bullying over text messages that could contribute to suicides.

The requirement that teachers undergo suicide prevention education reaches back to 2005 legislation that established the current requirement. Gov. Richard Codey signed the bill into law in 2006, making New Jersey the first state in the country to enact such a requirement.

New Jersey has a youth suicide rate of about 5 per 100,000 people, compared with nearly 8 per 100,000 nationally in 2012, the most recently available statistics from the New Jersey Department of Children and Families. The report defines youth as people from ages 10 to 24.

Suicide is the third leading cause of death among 10- to 24-year-olds in New Jersey. From 2011 to 2013, 232 people in that age group committed suicides, according to the department….                           http://www.deseretnews.com/article/765667095/Teachers-would-get-more-training-on-suicide-under-bill.html

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes; it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let me add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Resources:

Suicide Prevention                                                                                                                             http://www.cdc.gov/violenceprevention/pub/youth_suicide.html

Teen Suicide Overview                                                                                                                     http://www.teensuicidestatistics.com/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

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Harvard study: High doses of antidepressants appear to increase risk of self-harm in children and young adults

29 Apr

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Medical Press reported in the article, High doses of antidepressants appear to increase risk of self-harm in children young adult:

Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk….
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude. http://medicalxpress.com/news/2014-04-high-doses-antidepressants-self-harm-children.html

Citation:

Online First >
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Original Investigation|April 28, 2014
Antidepressant Dose, Age, and the Risk of Deliberate Self-harm
ONLINE FIRST
Matthew Miller, MD, ScD1; Sonja A. Swanson, ScM2; Deborah Azrael, PhD1; Virginia Pate, PhD, PhD3; Til Stürmer, MD, ScD3
[+] Author Affiliations
JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053
Text Size: A A A
Article
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Comments
ABSTRACT
ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Importance A comprehensive meta-analysis of randomized trial data suggests that suicidal behavior is twice as likely when children and young adults are randomized to antidepressants compared with when they are randomized to placebo. Drug-related risk was not elevated for adults older than 24 years. To our knowledge, no study to date has examined whether the risk of suicidal behavior is related to antidepressant dose, and if so, whether risk depends on a patient’s age.
Objective To assess the risk of deliberate self-harm by antidepressant dose, by age group.
Design, Setting, and Participants This was a propensity score–matched cohort study using population-based health care utilization data from 162 625 US residents with depression ages 10 to 64 years who initiated antidepressant therapy with selective serotonin reuptake inhibitors at modal or at higher than modal doses from January 1, 1998, through December 31, 2010.
Main Outcomes and Measures International Classification of Diseases, Ninth Revision (ICD-9) external cause of injury codes E950.x-E958.x (deliberate self-harm).
Results The rate of deliberate self-harm among children and adults 24 years of age or younger who initiated high-dose therapy was approximately twice as high as among matched patients initiating modal-dose therapy (hazard ratio [HR], 2.2 [95% CI, 1.6-3.0]), corresponding to approximately 1 additional event for every 150 such patients treated with high-dose (instead of modal-dose) therapy. For adults 25 to 64 years of age, the absolute risk of suicidal behavior was far lower and the effective risk difference null (HR, 1.2 [95% CI, 0.8-1.9]).
Conclusions and Relevance Children and young adults initiating therapy with antidepressants at high-therapeutic (rather than modal-therapeutic) doses seem to be at heightened risk of deliberate self-harm. Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that antidepressant dose is generally unrelated to therapeutic efficacy, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to closely monitor patients starting antidepressants, especially youth, for several months.

Here is the press release from Harvard:

PUBLIC RELEASE DATE:
28-Apr-2014

Contact: Marge Dwyer
mhdwyer@hsph.harvard.edu
617-432-8416
The JAMA Network Journals
High doses of antidepressants appear to increase risk of self-harm in children young adult
Bottom Line:
Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
Author:
Matthew Miller, M.D., Sc.D., of the Harvard School of Public Health, Boston, and colleagues.
Background:
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
How the Study Was Conducted:
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
Results: The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk.
Discussion: “Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that dose is generally unrelated to the therapeutic efficacy of antidepressants, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to monitor all patients starting antidepressants, especially youth, for several months and regardless of history of DSH.”
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made a conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Initial Dose of Antidepressants, Suicidal Behavior in Youth
In a related commentary, David A. Brent, M.D., of the University of Pittsburgh, and Robert Gibbons, Ph.D., of the University of Chicago, write: “In summary Miller et al are to be commended on a thoughtful and careful analysis of the effects of initiating antidepressants at higher than modal doses.”
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude.
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2013.14016. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
###
Media Advisory:
To contact author Matthew Miller, M.D., Sc.D., call Marge Dwyer at 617-432-8416 or email mhdwyer@hsph.harvard.edu. To contact commentary author David A. Brent, M.D., call Gloria Kreps at 412-586-9764 or email krepsga@upmc.edu.

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention

Resources:

Teen’s Health’s Suicide http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx
Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression http://helpguide.org/mental/depression_teen.htm

Jared Story.Com http://www.jaredstory.com/teen_epidemic.html
CNN Report about suicide http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html
American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

Youth Suicide Prevention
About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:
University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations https://drwilda.com/tag/depression/

GAO report: Children’s mental health services are lacking https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:
COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

University of Florida tries the online counseling program Therapist Assisted Online (TAO)

20 Jan

When parents are packing their children off to college, some are sending children to school who have some severe mental health and emotional issues. Trip Gabriel has an article in the New York Times which outlines the issues some students face while they are at college. In Mental Health Needs Growing At Colleges Gabriel reports:

Stony Brook is typical of American colleges and universities these days, where national surveys show that nearly half of the students who visit counseling centers are coping with serious mental illness, more than double the rate a decade ago. More students take psychiatric medication, and there are more emergencies requiring immediate action.
“It’s so different from how people might stereotype the concept of college counseling, or back in the ’70s students coming in with existential crises: who am I?” said Dr. Hwang, whose staff of 29 includes psychiatrists, clinical psychologists and social workers. “Now they’re bringing in life stories involving extensive trauma, a history of serious mental illness, eating disorders, self-injury, alcohol and other drug use.”
Experts say the trend is partly linked to effective psychotropic drugs (Wellbutrin for depression, Adderall for attention disorder, Abilify for bipolar disorder) that have allowed students to attend college who otherwise might not have functioned in a campus setting.
There is also greater awareness of traumas scarcely recognized a generation ago and a willingness to seek help for those problems, including bulimia, self-cutting and childhood sexual abuse.
The need to help this troubled population has forced campus mental health centers — whose staffs, on average, have not grown in proportion to student enrollment in 15 years — to take extraordinary measures to make do. Some have hospital-style triage units to rank the acuity of students who cross their thresholds. Others have waiting lists for treatment — sometimes weeks long — and limit the number of therapy sessions.
Some centers have time only to “treat students for a crisis, bandaging them up and sending them out,” said Denise Hayes, the president of the Association for University and College Counseling Center Directors and the director of counseling at the Claremont Colleges in California.
“It’s very stressful for the counselors,” she said. “It doesn’t feel like why you got into college counseling.”
A recent survey by the American College Counseling Association found that a majority of students seek help for normal post-adolescent trouble like romantic heartbreak and identity crises. But 44 percent in counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.
The most common disorders today: depression, anxiety, suicidal thoughts, alcohol abuse, attention disorders, self-injury and eating disorders.
If a student has had prior problems, the student and family should have a plan for dealing with issues like depression or eating disorders while the student is at college. Often that might include therapy sessions with a counselor near the college. Often, students and families do not want to seek help because many feel there is a stigma to mental illness.
Megan O’Neill reported in the Chronicle of Higher Education article, Campus Psychological Counseling Goes Online for Students at U. of Florida which discussed the online counseling program Therapist Assisted Online (TAO):
Therapist Assisted Online, or TAO, began at Florida this past fall. Designed specifically for students battling anxiety—a primary mental-health issue on college campuses—it is the first research-supported program of its kind in the United States, Ms. Benton believes.
In the pilot program, 26 students treated under TAO showed more improvement, calculated using a system called Behavioral Health Measure­-20, than 26 participants in the in-person group-therapy sessions at the counseling center. The students treated under TAO also made more progress than about 700 students receiving individual in-person therapy.
“The results blew me away, not to mention the fact that it stunned all of my counselors, who I think are still trying to come to terms with what happened,” Ms. Benton says.
The director is the first to point out the limitations of the pilot. Both the student patients and the counselors self-selected, indicating a certain level of motivation and comfort with new technology. The pool of participants was small. Other research studies show that online patients experience results equal to those of in-person patients.
Still, the model could spell major change for mental-health services in higher education, where the number of students in need of treatment and the severity of diagnoses has climbed steadily during the past decade, according to professionals in the field…
TAO consists of seven interactive treatment modules meant to be completed during a seven-week period. It includes assessments of current symptoms and level of function, as well as cognitive–behavorial and mindfulness exercises. Student patients participate in 10- to 15-¬minute video consultations with their counselors once a week, and receive daily encouraging text messages.
The online-treatment program falls between self-help and traditional therapy, Ms. Benton says. The relationship between the counselor and the patient remains paramount. The weekly video consultations and the content of the modules work in concert.
Counselors monitor progress, and layers of risk management are in place. Participating students must provide emergency contact information and authorize the counseling center to use it, if necessary.
Jurisdictional Issues
Much of the technical work is being done within the E-Learning, Technology, and Creative Services division of the university’s College of Education. Glenn E. Good, dean of the college and a licensed psychologist, estimates that the university has spent about $200,000 to develop TAO.
Officials are exploring the licensing potential of the program, he says, although the priority is to produce an effective, replicable treatment rather than a profitable business.
TAO and other types of online psychotherapy are inappropriate for seriously ill patients, counselors at the University of Florida and others say. Moreover, the regulation of mental-health professionals in the United States is done at the state level, creating geographic limitations even though the treatment is done online.
“There are interjurisdictional problems,” says John C. Norcross, a researcher and professor of psychology at the University of Scranton. “If you launch a website in Pennsylvania and the therapist you are talking to is in Florida and the patient is Louisiana, it is a regulatory and malpractice nightmare.”
Where the licensing and regulation of mental-health professionals is done at the national level, such as in Australia and Britain, online psychotherapy has been in use for years, Mr. Norcross says.
Nevertheless, TAO promises clear advantages for mental-health professionals in higher education and their patients, experts say. They cite time and cost savings, the flexible and discreet nature of delivery, and the potential scalability…. http://chronicle.com/article/Campus-Psychological/143963/

The University of Florida describes TAO:

What is TAO?
Tao is a seven-week, interactive, web-based program that provides assistance to help overcome anxiety.
TAO is based on well research and highly effective strategies for helping anxiety.
Each of the seven weeks, participants will watch videos, complete exercises, and meeting with a counselor via video conferencing for a 10-15 minute consultation.
Weekly exercises taking approximately 30-40 minutes to complete.

What are the experiences of UF students using TAO?
TAO Pilot OutcomesDuring the Fall 2013 Semester, we compared outcomes for individual face-to-face psychotherapy, group psychotherapy and Therapist Assisted Online for students with anxiety across seven sessions.
All participants completed the Behavioral Health Measure-20 (BHM-20) prior to each session.
On the BHM-20 higher scores indicate fewer symptoms and better functioning. The graph on the right shows change across time on the anxiety subscale of the BHM-20. On the BHM-20 a score of 2.6 indicates normal non-problematic functioning.

Who is eligible?
Currently enrolled students who want help with anxiety and worry.
Students who have access to computer with webcam.
Students who are not experiencing severe depression.
Students without a current substance abuse problem.
If taking medication, must have been on the same dose for at least one month prior to starting the treatment.
18 years old or older.
Currently living within 50 miles of Gainesville.
How do I sign up?
Call the Counseling and Wellness Center and ask to schedule a TAO triage appointment.
If you are already seeing a counselor, then tell your counselor you are interested.

We look forward to helping with your anxiety in TAO!
http://www.counseling.ufl.edu/cwc/tao

Parents must recognize the signs of distress and get help for their child. If you are a student in distress, get help because there are many different therapies to get you back on track.

Resources for Parents & Students

◦National Resources http://www.mentalhealthamerica.net/go/help/find-national-resources

◦National Suicide Prevention Lifeline: 1-800-273-TALK (8255) http://www.suicidepreventionlifeline.org/24 hour hotline

◦Mental Health America screenings for depression and other mental health conditions http://www.mentalhealthamerica.net/go/help/ Click on the Take a Screening link under Finding Help
◦mpowersheets http://www.mpoweryouth.org/411.htmmpower is a youth awareness campaign that helps fight stigma

◦The Virginia Tech Tragedy: Tips and Resources http://www.mentalhealthamerica.net/go/about-us/pressroom/press-kits/virginia-tech

◦Active Minds http://www.activemindsoncampus.org/Peer to Peer student support and advocacy group on college campuses

◦NAMI on Campus http://www.nami.org/Content/NavigationMenu/Find_Support/NAMI_on_Campus1/NAMI_on_Campus.htm

Student-run organizations that provide support, education, and advocacy

◦Disability and Civil Rights Resources http://www.bazelon.org/issues/education/StudentsandMentalHealth.htm#2Explains rights under ADA and how to file a discrimination complaint

◦Education and Community Integration http://www.upennrrtc.org/issues/view.php?id=6Overview of importance of community integration for those with mental health conditions

◦Community Integration Tools http://www.upennrrtc.org/var/tool/file/26-CollegeFS.pdfThe College Experience: Tips for Reducing
Stress and Getting the Accommodations You Need

◦Center for Psychiatric Rehabilitation http://www.bu.edu/cpr/reasaccom/index.html#topInformation on reasonable accommodations

◦Job Accommodation Network http://www.jan.wvu.edu/portals/ed.htmSection on accommodations in educational settings

◦Association on Higher Education and Disability http://www.ahead.org/

◦Office of Civil Rights, Department of Education http://www.ed.gov/about/offices/list/ocr/complaintprocess.htmlComplaint form and procedures

Trauma Resources

◦Understanding Mental Illness After the Virginia Tech Tragedy http://www.samhsa.gov/MentalHealth/understanding_Mentalllness.aspxTips for dealing with trauma as well as educational resources

◦Higher Education Resources on Violence http://www.higheredcenter.org/violence/

◦Preventing Violence and Promoting Safety in Higher Education Settings http://www.higheredcenter.org/pubs/violence.pdf

Evaluation Resources

◦Guide by Department of Education http://www.ed.gov/PDFDocs/handbook.pdfA guide to evaluating drug and alcohol prevention projects

◦Resources through the Higher Education Center http://www.higheredcenter.org/eval/links.html

Mental Health Screening Tools

◦Screening For Mental Health http://www.mentalhealthscreening.org/index.aspxA non-profit with college screening programs

◦Teenscreen http://www.teenscreen.org/Columbia University’s mental health screening program

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Study: Current therapies may not be effective in preventing teen suicide, but targeted treatment helps

8 Jan

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Why Do Teens Attempt Suicide?

The American Academy of Adolescent Psychiatry has some excellent suicide resources

Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.

Teenagers experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while growing up. For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems and stress.

Sometimes, people see suicide as an answer to their problems. All of us must stress that suicide is always the WRONG answer to what in all likelihood is a transitory situation.

What are the Warning Signs of Suicide?

According to Teen’s Health there are some suicide warning signs

Warning Signs

There are often signs that someone may be thinking about or planning a suicide attempt. Here are some of them:

talking about suicide or death in general

talking about “going away”

referring to things they “won’t be needing,” and giving away possessions

talking about feeling hopeless or feeling guilty

pulling away from friends or family and losing the desire to go out

having no desire to take part in favorite things or activities

having trouble concentrating or thinking clearly

experiencing changes in eating or sleeping habits

engaging in self-destructive behavior (drinking alcohol, taking drugs, or cutting, for example)

These are signs that indicate a person may be depressed.

According to JaredStory.com the primary cause of suicide is depression.

# 1 CAUSE OF SUICIDE: UNTREATED DEPRESSION

It can be very hard to diagnose depression. There are many different kinds of depression and not all people will have the same symptoms, or have them to the same degree. Here are some symptoms to watch for and if they last more than a few weeks, a doctor or psychiatrist should be consulted.

Persistent sad or “empty” mood

Feeling hopeless, helpless, worthless

pessimistic and or guilty

Substance abuse

Fatigued or loss of interest in ordinary activities

Disturbances in eating and sleeping patterns

Irritability, increased crying, anxiety and panic attacks, (Post Traumatic Stress Disorder)

Difficulty concentrating, remembering or making decisions

Thoughts of suicide; suicide plans or attempts

Persistent physical symptoms or pains that do not respond to treatment

The site also lists events that might trigger depression in a person.

A death of a family member or close friend – which could include a fellow student from school

An assault, car accident or painful physical event – which could include physical bullying

Mental, or emotional event – which could include non-physical bullying

Marriage breakup, or love lost suddenly – which could include “breaking up” with a girlfriend or boyfriend

Constant physical, mental, or emotional pain that goes on for a length of time – which includes constant bullying that is not intervened, resolved or stopped entirely

Major Financial setback – which includes a teenager who may have lost a job

Something “embarrassing” happens – as an example; getting kicked off a football team or a public insult by a teacher or popular student; bullying

Failing an important exam a school – not a normal trigger unless the exam was life changing and the individual is under a lot of stress

A best friend moves out of town – especially true for teenagers who are being bullied and have very few friends as it is

If you notice these signs, the key is to get help for yourself or a friend. The type of treatment will depend upon the underlying symptoms.

Benedict Carey reports in the New York Times article, Study Questions Effectiveness of Therapy for Suicidal Teenagers:

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference. ..

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies. http://www.nytimes.com/2013/01/09/health/gaps-seen-in-therapy-for-suicidal-teenagers.html?hp&_r=0

See, A Tragedy and a Mystery http://harvardmagazine.com/2011/01/tragedy-and-mystery

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center has some excellent advice about suicide prevention

Resources

Teen’s Health’s Suicide

American Academy of Adolescent Psychiatry

Suicide Prevention Resource Center

Teen Depression

Jared Story.Com

CNN Report about suicide

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

Youth Suicide Prevention

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