摘要:

Dr. Margaret Bean‐Bayog, a Boston psychiatrist, was sued by the Lozano family after a former patient, Paul Lozano, committed suicide. The case was widely and sensationally publicized in the newspapers and other media. A combination of inaccurate reporting, inept proceedings by the Massachusetts Board of Registration in Medicine, and the threat of ruinous legal fees led Dr. Bean‐Bayog to surrender her license to practice medicine. Facts that were not reported in the press were described in Dr. Maltsberger's address, delivered on April 15, 1992, at the annual AAS meeting in San Francisco. The implications for therapists attempting to treat seriously suicidal patients in the current hostile forensic climate were further discussed. The text of the address is presented h

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The main assertion in this paper is thatpsychache(mental pain) has a life of its own and is separate from the study of the brain, the organ that cradles the processes of the mind. No amount of biologicizing or medicalizing suicide can gainsay the fact that the human impulse of self‐destruction is a decision of mind to put an end to the flow of its own unbearable conscious contents, to stop the psychache. The explanations for suicidal actions lie in the Oxford English Dictionary, not in the Diagnostic and Statistical Manual of Mental Disorders. Unless suicidology asserts and maintains the position that suicide is essentially psychachical, that the main focus of suicidal action is in the mind (as opposed to the mind's somatic abode, the brain), it will lose its identity and its usefulness. This is not just a quarrel over professional territory, money, or power; it is a philosophic war, a fight for the very soul of suicidology–and of the m

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This paper presents an argument for a paradigm shift in the way that mental health professionals approach their work with psychiatric patients in the midst of a suicidal crisis and suggests that the time has come to discuss a standard of care based on integration of detected risk factors, effective education and training in suicidology, and most importantly, the routine use of consultation and teamwork. Also proposed is a workable model for the use of consultation that has a number of major components: quality education in suicidology, the training and availability of appropriate consultants, clinical teamwork, and the recognition by training programs and clinical institutions that it is necessary to routinely consider a consultative risk management approach for work with suicidal patients.

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Many researchers have claimed that the study of suicide and the formation of public policy are not undermined by the misclassification of suicide as other causes of death. We evaluated this claim using a new technique and causes of death not previously considered. We examined computerized California death certificates, 1966‐1990. Mortality peaks at symbolic ages are a characteristic feature of suicide. We sought such peaks in (1) causes of death commonly suspected of containing misclassified suicides (e.g., accidental barbiturate poisoning), (2) causes of death not hitherto suspected (e.g., pedestrian deaths), and (3) control groups. The first two categories displayed peaks at symbolic ages, but control groups did not. The size of the peak, indicative of misclassified suicides, varied markedly by race (p<.0001) and sex (p<.0001). Misclassification is evident for all time periods examined, large and small counties, and each race and sex. The maximum misclassification occurs for Blacks (14.92% of officially recorded suicides). We conclude that suicides are misallocated to at least five other causes of death (two of which have not been previously considered in the literature) and are most likely to be underreported for groups with low official suicide rates, that is, Blacks and females. Consequently, Blacks and females are not as protected from suicide as was previously supposed. It may be inadvisable to use official suicide data to test scientific hypotheses about suicide, unless the effects of underreporting are estimated and, if necessary, corrected fo

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00201.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The importance of previous suicidal behavior for the treatment of alcoholics was analyzed in a long‐term outpatient treatment study. In a series of 72 patients, 21 patients, (29%), 17 men and 4 women, had previously made at least one suicide attempt or had seriously threatened to kill themselves (3 cases). In comparison with the other alcoholics, those with previous suicidal behavior had a similar attrition rate, they were not more troublesome in treatment, and they had the same rate of favorable outcome during the third year after start of treatment. They differed from the other alcoholics in having a more severe abuse and a less favorable outcome during the initial part of the treatment. In conclusion, our results support the possibility of a long‐term outpatient treatment strategy in alcoholics with previous suicide attem

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00202.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A review of all English‐language studies (14 foreign and 17 American) on campus student suicides was undertaken. Only studies reporting original data and containing sufficient demographic information to compute standard mortality rates (SMR) or crude suicide rates were analyzed and organized into single‐site studies. Only 4 single‐site studies had a higher suicide rate than the comparable populations. Multiple‐site collaborative studies done in the United States since 1960 strongly suggest a campus student suicide rate significantly less than in the matched control population. However, deficiencies in case finding, case definition, sampling bias, and statistical techniques may place these conclusions in doubt. The author outlines research methods that might be applied to future multiple‐site studies to resolve questions related to late adolescent and young adult suicidal behavior on campus and in other similar educational

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00203.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In a conceptual framework of suicide process, literature on life events and social support in suicide is reviewed. Few studies have centered on these issues, and the existing research has many methodological ambiguities. However, it can be concluded that life events play an important role in suicide process as risk and precipitating factors. The findings on disintegration of social networks and poor social support indicate lack of protective factors. Implications for future research are discussed. Further research focusing on more specific questions on the role of life events and social support as well as their interactions is needed.

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The adolescent years, being a period of unique developmental changes, are of great interest in understanding suicidal behavior. The occurrence of completed suicide by age in 1‐year age groups in adolescence and young adulthood was studied via official Finnish mortality statistics and the population statistics. Suicide rates increased sharply by age during adolescence, starting somewhat earlier among boys than among girls. During the periods of rapidly rising and high suicide rates in the 1970s and 1980s among boys, the increase in suicide rates started at a younger age than during a spell of lower rates in the 1960

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A high rate of suicide attempts and suicide ideation characterized a sample of 229 grade 7 to 9 adolescents resident on seven reserves in central Alberta. The prevalence of suicidality for these adolescent Indians was very similar to rates reported for Navajo youth and for 8th‐ and 10th‐grade American non‐Indian students. Comparison of Indian and non‐Indian suicidality risk factors showed somewhat elevated levels of family disruption and psychological problems among Indian adolescents. Compared to Canadian nonadolescents, substance abuse levels were high, and conditions necessary to modeling were virtually omnipresent. Suicide ideation was significantly elevated for Indian adolescents with low psychological well‐being, no father in the home, and a prior suicide in the household. Controlling for age, risk factors for suicide attempts were heavy alcohol use, no father in the home, sleeping problems, and low psychological well‐being. The high rates of adolescent Native suicide imply that a much higher proportion of their suicide attempts succeed. Targeted, community‐based counselling and educational programs are needed to address t

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0363-0234    

DOI:10.1111/j.1943-278X.1993.tb00207.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY