Objective:To identify the most frequent gender-specific suicide methods in Europe.Design:Proportions of seven predominant suicide methods utilised in 16 countries participating in the European ...Alliance Against Depression (EAAD) were reported in total and cross-nationally. Relative risk (RR) relating to suicide methods and gender was calculated. To group countries by pattern of suicide methods, hierarchical clustering was applied.Setting and participants:Data on suicide methods for 119 122 male and 41 338 female cases in 2000–4/5 from 16 EAAD countries, covering 52% of European population were obtained.Results:Hanging was the most prevalent suicide method among both males (54.3%) and females (35.6%). For males, hanging was followed by firearms (9.7%) and poisoning by drugs (8.6%); for females, by poisoning by drugs (24.7%) and jumping from a high place (14.5%). Only in Switzerland did hanging rank as second for males after firearms. Hanging ranked first among females in eight countries, poisoning by drugs in five and jumping from a high place in three. In all countries, males had a higher risk than females of using firearms and hanging and a lower risk of poisoning by drugs, drowning and jumping. Grouping showed that countries might be divided into five main groups among males; for females, grouping did not yield clear results.Conclusions:Research on suicide methods could lead to the development of gender-specific intervention strategies. Nevertheless, other approaches, such as better identification and treatment of mental disorders and the improvement of toxicological aid should be put in place.
Le but poursuivi dans cet article est de préciser le rôle des troubles anxieux envisagés globalement ou séparément (incluant la phobie sociale, la phobie spécifique, le trouble obsessionnel ...compulsif, le trouble anxieux généralisé, l'état de stress post-traumatique et le trouble panique) comme facteurs de risque causaux potentiels dans l'apparition de la dépression ainsi que des troubles liés à l'utilisation d'alcool. Certains troubles anxieux seraient primaires à d'autres troubles mentaux et entraîneraient une augmentation du risque d'apparition subséquente de ces derniers. Dans cette revue, nous avons réalisé une recherche par ordinateur (Pubmed) de travaux publiés sur le sujet, en reprenant principalement des études prospectives récentes. Plusieurs études suggèrent que certains troubles anxieux, leur nombre et leur sévérité augmenteraient significativement le risque d'apparition ultérieure de la dépression et des troubles liés à l'utilisation d'alcool. Cependant, les auteurs ne sont pas unanimes sur ce sujet. Déterminer précisément si les divers troubles anxieux constituent des facteurs de risque causaux permettrait de mieux comprendre l'étiologie de certains troubles mentaux, d'améliorer l'efficacité du diagnostic et de développer des interventions préventives et thérapeutiques effectives.
The object of this paper is to specify the role of anxiety disorders taken as a group or separately (including panic disorder, social phobia, specific phobia, obsessive-compulsive disorder, generalized anxiety disorder and post-traumatic stress disorder) as potential causal risk factors for depression and alcohol use disorders. Several studies have consistently suggested that some anxiety disorders are primary to other mental disorders in a majority of co-morbid cases and could increase the risk of their onset. We performed a computerized search (Pubmed) on recent published studies on this subject. We focused on recent prospective studies. Several findings have confirmed that the number and severity of some primary anxiety disorders may significantly increase the risk of subsequent mental disorders (such as depression and alcohol use disorders). However, the authors are not unanimous on this subject. A precise determination of whether various anxiety disorders could constitute causal risk factors for subsequent mental disorders would permit a better understanding of disease aetiology, improve the efficiency of diagnosis and would allow development of effective interventions.
Chez les migrants, les études cliniques soulignent une plus grande prévalence des troubles psychotiques. Les facteurs avancés sont multiples (génétiques, psychotiques, induits par des substances…). ...Il y a deux explications, souvent étayées par les études, sur lesquelles nous souhaitons développer cet article
: le biais diagnostique et le mode d'entrée en contact du patient avec le système de soins. Nous utiliserons un cas clinique d'une jeune femme d'origine burundaise qui décompense sur un mode psychotique. Elle est amenée aux urgences par la police
; elle présente une bouffée délirante réactionnelle à des problèmes de couple. Après une mise en observation (
a posteriori non justifiée), elle reçoit un traitement antipsychotique qui lui permet de regagner rapidement son domicile. La discussion s'articule d'abord autour du diagnostic de bouffée délirante et de son diagnostic différentiel avec la schizophrénie. Le deuxième point de la discussion concerne la voie par laquelle les sujets migrants prennent contact avec le système de soins, notamment à travers le recours plus systématique aux services d'urgences. Nous aborderons également la question du biais diagnostique dont sont fréquemment victimes les patients migrants. Le troisième point porte sur la perception de la maladie mentale dans les familles de patients migrants. Enfin, le quatrième point souligne la nécessité de prendre en considération l'existence d'éléments traumatiques antérieurs chez les sujets migrants, principalement chez ceux qui ont migré pour des raisons politiques.
Clinical studies show a higher prevalence of psychotic diseases among migrant patients. There are multiple suggested factors for this prevalence: Genetic, psychotic, factors induced by substances… We have based this article on two explanations often supported by studies: The diagnostic bias and the way migrant patients are contacted within the care system. The case we have studied is that of a young Burundian woman who decompensated in a psychotic mode. When she was brought to the emergency ward by the police she was suffering a delirious episode due to problems in her marriage. After a forced hospitalisation (unjustified a posteriori) she was given an antipsychotic treatment which allowed her to go home after a short time. We have articulated the first part of the discussion around the diagnosis of a delirious episode and its difference with a diagnosis of schizophrenia. The second point of the discussion concerns the way migrants get in touch with the care system: Notably by a more systematic appeal to the emergency units. We have also approached the question of the diagnostic bias migrant patients are frequently victims of. The third point of the discussion concerns the perception families of migrant patients have of mental illness. Finally, the fourth point of the discussion underlines the necessity of considering the existence of previous traumatic events of migrant subjects, mainly among those who have migrated for political reasons.
Most psychiatric disorders present symptom patterns that cause severe impairment on the emotional, cognitive and social level. Thus, adolescents who suffer from a mental disorder risk finding ...themselves in a downward spiral caused by the reciprocal association of psychological symptoms and negative school experiences that may culminate in early school leaving. In addition to previous collective work that mainly focused on school refusing behaviour among children and was presented as an expert's opinion, the following systematic review fills the knowledge gap by providing a structured overview of the bidirectional association between mental health and secondary school dropout based on a sound methodology and with a particular focus on mediating factors.
Four electronic databases were searched from January 1990 until June 2014. Selected references were assessed for study details, main results, mediating factors and methodological limitations. Standardized risk of bias assessment was conducted.
Mood and anxiety disorders seemed to have a less consequential direct effect on early school leaving than substance use and disruptive behaviour disorders. The association between externalizing disorders and educational attainment was even stronger when the disorder occurred early in life. On the other hand, internalizing disorders were reported to develop as a consequence of school dropout. Only few studies had addressed gender differences, with discrepant results. Socio-economic background, academic achievement and family support were identified as significant mediating factors of the association between mental disorders and subsequent educational attainment.
Findings suggested a strong association between mental health and education, in both directions. However, most studies focused on mediating factors that could not be targeted by intervention programs.
The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments is an international study which has taken place in 12 centres in ten countries, aiming to test the ...reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, κ) were very good for dependence disorders (0.7–0.9), but were somewhat lower for abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.
Taste preference and psychopathology Aguayo, G A; Vaillant, M T; Arendt, C ...
Bulletin de la Société des sciences médicales du Grand-Duché de Luxembourg,
2012
2
Journal Article
Peer reviewed
Excessive food intake has been linked to many factors including taste preference and the presence of psychopathology. The purpose of this study was to investigate the association between sweet and ...salty taste preference and psychopathology in patients with severe obesity.
A consecutive series of patients applying for bariatric surgery was recruited for the study. Taste preference was self-reported. Psychopathology was assessed using the revised version of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). 190 patients were included in the study.
In comparison with patients who had salty taste preference, patients with sweet taste preference had significantly higher elevations on the depression (OD: 4.090, p = 0.010) and the hysteria (OD: 2.951, p = 0.026) clinical scales of the MMPI-2.
The results suggest the presence of an association between taste preference and psychopathology. The findings may be of interest for clinicians who are involved in the treatment of obesity. In particular, they may wish to pay increased attention to patients with sweet taste preference or who have a strong attraction for both sweet and salty foods, in order to detect psychopathology and to adapt the treatment.
The present editorial review examines current psychological assessment practices in obesity surgery programs, reasons for making such assessments and data obtained prior to surgery and during ...follow-up. It summarizes findings from previous review articles and reports on new research findings that have been published between August 2006 and August 2009.
Patients with morbid obesity applying for weight loss are commonly administered extensive psychiatric and psychological assessment prior to surgery. Although the value of psychopathological factors for predicting weight loss and mental health after surgery remains controversial, the presence of psychopathology should be taken into account in the presurgery as well as in the postsurgery management of patients undergoing weight-loss surgery.
Morbid obesity is associated with high rates of psychopathology, including depression, anxiety, eating disorders, abnormal personality traits and personality disorders. There is a decrease in psychopathology after obesity surgery in many, though not all, individuals. There is some evidence for poorer postsurgery outcome in individuals with significant presurgery psychopathology, but there is a clear need for more substantial information with regard to reliable psychological predictors of weight loss and mental health after surgery. Whatever the predictive value of psychopathology prior to surgery, it is essential to detect patients in need of psychiatric and/or psychological support after surgery.
L’état de stress post-traumatique (ESPT) est un trouble fréquent, invalidant et souvent chronique qui est associé à un coût social et personnel important. Diverses approches thérapeutiques ont fait ...l’objet d’études témoins et randomisées : les approches médicamenteuses, psychothérapeutiques (essentiellement cognitivocomportementales) et combinant médicaments et psychothérapie. Cet article se limite à passer en revue les données empiriques sur les traitements de l’ESPT par des antidépresseurs (inhibiteurs sélectifs de la recapture de sérotonine, inhibiteurs de la recapture de la noradrénaline et de la sérotonine, inhibiteurs sélectifs des récepteurs alpha-2 sérotoninergiques, tricycliques, inhibiteurs de la monoamine-oxydase) et suggère quelques recommandations à partir des données disponibles dans la littérature scientifique. La recherche complète des données sur PubMed/Medline révèle une multitude de rapports de cas et d’études ouvertes. Nous avons décidé de limiter notre revue de la littérature aux études témoins randomisées en double insu concernant le traitement par antidépresseurs de l’ESPT. Il ressort de cette revue que la plupart des antidépresseurs ont une action positive sur certains symptômes de l’ESPT, mais que leur efficacité à court terme n’est que partielle et qu’il persiste des inconnues sur leur efficacité à long terme. Les données actuelles basées sur les résultats des études témoins randomisées en double insu suggèrent que les traitements médicamenteux de première ligne en monothérapie dans l’ESPT sont les inhibiteurs sélectifs de la recapture de sérotonine. D’autres options potentielles incluent des monothérapies avec les inhibiteurs de la recapture de la noradrénaline et de la sérotonine, les inhibiteurs sélectifs des récepteurs alpha-2 sérotoninergiques, les antidépresseurs tricycliques, les inhibiteurs de la monoamine-oxydase, ainsi que l’ajout d’autres traitements médicamenteux dans les cas des ESPT résistants. Il semble exister un certain consensus sur le fait que le traitement devrait être poursuivi pendant une durée prolongée, dépassant très largement la durée de trois mois habituellement utilisée dans les essais témoins et randomisés. Dans les cas des ESPT chroniques avec des symptômes résiduels, un traitement d’au moins 12 mois paraît indiqué.
Posttraumatic stress disorder (PTSD) can be a prevalent, often chronic and disabling condition with major consequences for the individual and society. Diverse therapeutic approaches made the object of controlled and randomized studies: the pharmacological approach, the psychotherapic approach (essentially cognitivobehavioral), and the approaches combining pharmacology and psychotherapy. This article tries to review the available empirical data on antidepressant approaches to PTSD (selective serotonin re-uptake inhibitors, monoamine-oxydase inhibitors, tricyclic antidepressants, serotonin-norepinephrine re-uptake inhibitor) and to provide some recommendations for clinical practice. Although a comprehensive search of PubMed/Medline databases revealed a great number of case reports and open-label trials, we decided to focus primarily on evidence obtained from randomized controlled trials to determine the most effective antidepressant treatments for PTSD. Antidepressant pharmacotherapy seems to have positive effect on certain symptoms of PTSD but their short-term efficacy is partial and there remains unknown data on their long-term effectiveness. The available data supports antidepressant medication as the first-line pharmacotherapy for PTSD, with selective serotonin re-uptake inhibitors monotherapy having the strongest body of empirical support. Other potential options include, serotonin-norepinephrine re-uptake inhibitor, selective alpha-2 presynaptic serotoninergic inhibitors, monoamine-oxydase inhibitors or tricyclic antidepressants, and the combination with other pharmacotherapy in refractory PTSD cases. It seems to exist a certain consensus on the fact that the treatment should be continued for one prolonged length of time, exceeding largely the three months duration usually used in the controlled and randomized studies. A 12-month treatment seems indicated in chronic PTSD with residual symptoms.
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