Can We Really Prevent Suicide?

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Prevention strategies found to be effective in suicide prevention include means restriction, responsible media coverage, and general public education, as well identification methods such as screening, gatekeeper training, and primary care physician education. Although the treatment for preventing suicide is difficult, follow-up that includes pharmacotherapy, psychotherapy, or both may be useful. However, prevention methods cannot be restricted to the individual. Community, social, and policy interventions will also be essentia

Measuring Dysfunctional Attitudes in the General Population: The Dysfunctional Attitude Scale (form A) Revised

The Dysfunctional Attitude Scale (DAS) was designed to measure the intensity of dysfunctional attitudes, a hallmark feature of depression. Various exploratory factor analytic studies of the DAS form A (DAS-A) yielded mixed results. The current study was set up to compare the fit of various factor models. We used a large community sample (N = 8,960) to test the previously proposed factor models of the DAS-A using confirmatory factor analysis. The retained model of the DAS-A was subjected to reliability and validity analyses. All models showed good fit to the data. Finally, a two-factor solution of the DAS-A was retained, consisting of 17 items. The factors demonstrated good reliability and convergent construct validity. Significant associations were found with depression. Norm-scores were presented. We advocate the use of a 17-item DAS-A, which proved to be useful in measuring dysfunctional beliefs. On the basis of previous psychometric studies, our study provides solid evidence for a two-factor model of the DAS-A, consisting of ‘dependency’ and ‘perfectionism/performance evaluation’

The big five personality traits, perfectionism and their association with mental health among UK students on professional degree programmes

Background In view of heightened rates of suicide and evidence of poor mental health among healthcare occupational groups, such as veterinarians, doctors, pharmacists and dentists, there has been increasing focus on the students aiming for careers in these fields. It is often proposed that a high proportion of these students may possess personality traits which render them vulnerable to mental ill-health. Aim To explore the relationship between the big five personality traits, perfectionism and mental health in UK students undertaking undergraduate degrees in veterinary medicine, medicine, pharmacy, dentistry and law. Methods A total of 1744 students studying veterinary medicine, medicine, dentistry, pharmacy and law in the UK completed an online questionnaire, which collected data on the big five personality traits (NEO-FFI), perfectionism (Frost Multidimensional Perfectionism Scale), wellbeing (Warwick-Edinburgh Mental Well-being Scale), psychological distress (General Health Questionnaire-12), depression (Beck Depression Inventory-II) and suicidal ideation and attempts. Results Veterinary, medical and dentistry students were significantly more agreeable than law students, while veterinary students had the lowest perfectionism scores of the five groups studied. High levels of neuroticism and low conscientiousness were predictive of increased mental ill-health in each of the student populations. Conclusions The study highlights that the prevailing anecdotal view of professional students possessing maladaptive personality traits that negatively impact on their mental health may be misplaced

Prediction and prevention of suicide in patients with unipolar depression and anxiety

Epidemiological data suggest that between 59 and 87% of suicide victims suffered from major depression while up to 15% of these patients will eventually commit suicide. Male gender, previous suicide attempt(s), comorbid mental disorders, adverse life-situations, acute psycho-social stressors etc. also constitute robust risk factors. Anxiety and minor depression present with a low to moderate increase in suicide risk but anxiety-depression comorbidity increases this risk dramatically Contrary to the traditional psychoanalytic approach which considers suicide as a retrospective murder or an aggression turned in-wards, more recent studies suggest that the motivations to commit suicide may vary and are often too obscure. Neurobiological data suggest that low brain serotonin activity might play a key role along with the tryptophan hydroxylase gene. Social factors include social support networks, religion etc. It is proven that most suicide victims had asked for professional help just before committing suicide, however they were either not diagnosed (particularly males) or the treatment they received was inappropriate or inadequate. The conclusion is that promoting suicide prevention requires the improving of training and skills of both psychiatrists and many non-psychiatrists and especially GPs in recognizing and treating depression and anxiety. A shift of focus of attention is required in primary care to detect potentially suicidal patients presenting with psychological problems. The proper use of antidepressants, after a careful diagnostic evaluation, is important and recent studies suggest that successful acute and long-term antidepressant pharmacotherapy reduces suicide morbidity and mortality