Effectiveness of psychosocial treatments on suicidality in personality disorders.
ABSTRACT Axis II disorders, particularly borderline personality disorder, are highly associated with suicidal behaviours. This paper aims to evaluate treatment of suicidality in borderline personality disorder.
Systematic review of the empirical literature on the clinical effectiveness of psychosocial treatments in reducing suicidal behaviours in patients with personality disorders. A summary of empirical findings is presented, and recommendations for clinical practice are offered.
While there is currently a dearth of well-controlled treatment trials, interest in this field of research is growing, and several recent randomized controlled trials support the effectiveness of certain interventions.
Several different types of psychosocial interventions are associated with reductions in suicidal behaviour.
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ABSTRACT: The primary objective of this review article is to provide a coherent, systematic synthesis of the literature on the management of suicidality in schizophrenia that is relevant to the front-line clinician. Literature searches were conducted on MEDLINE (1996 to 2007) and PubMed (1993 to 2007), using the key words "schizophrenia" and "suicide," as well as references from the resulting articles. I used my own clinical experience to create fictional case examples to illustrate the applicability of the literature discussed in this paper. Suicidality in schizophrenia is high, and early detection relies on the appreciation and evaluation of the clinical manifestations of depression, despair, and hopelessness, as well as on the nature and severity of the psychotic experience itself, particularly in recent-onset patients with higher cognitive function and educational background. Clinical management includes ensuring immediate safety, the use of psychosocial techniques to address depression and psychosocial stressors, targeted pharmacotherapy for depression and psychosis, and adequate discharge planning. Clozapine is the only antipsychotic with good evidence for efficacy in decreasing suicidal behaviour in schizophrenia. The optimal management of suicidality in schizophrenia involves the incorporation of traditional bedside clinical skills, selection of psychosocial modalities based on individual needs, and selective pharmacotherapy directed primarily at psychotic and depressive symptoms.Canadian journal of psychiatry. Revue canadienne de psychiatrie 07/2007; 52(6 Suppl 1):59S-70S. · 2.55 Impact Factor
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ABSTRACT: This is Part 1 of a 2-part review of suicidal behaviour in children and adolescents. Part 1 explores the phenomenology and epidemiology of suicide in children and adolescents. Systematic review of the literature since 1966. Behaviours included within this spectrum are discussed and differentiated. The literature regarding the impact of demographic, social, and psychological risk factors is summarized. Suicide rates in youth are declining, but the reasons are speculative. Suicidal behaviour comprises a spectrum with differing frequencies and risk factors. While some risk factors are fixed, such as age and family history, others, such as psychiatric illness and stressors, may be amenable to intervention.Canadian journal of psychiatry. Revue canadienne de psychiatrie 07/2007; 52(6 Suppl 1):21S-33S. · 2.55 Impact Factor
Article: Caring for the suicidal patient.Canadian journal of psychiatry. Revue canadienne de psychiatrie 07/2007; 52(6 Suppl 1):5S-6S. · 2.55 Impact Factor