For more than half a decade, lithium has been successfully used to treat bipolar disorder. Worldwide, it is considered the first-line mood stabilizer. Apart from its proven antimanic and prophylactic effects, considerable evidence also suggests an antisuicidal effect in affective disorders. Lithium is also effectively used to augment antidepressant drugs in the treatment of refractory major depressive episodes and prevent relapses in recurrent unipolar depression. In contrast to many psychiatric drugs, lithium has outlasted various pharmacotherapeutic ‘fashions’, and remains an indispensable element in contemporary psychopharmacology. Nevertheless, data from pharmacogenetic studies of lithium are comparatively sparse, and these studies are generally characterized by small sample sizes and varying definitions of response. Here, we present an international effort to elucidate the genetic underpinnings of lithium response in bipolar disorder. Following an initiative by the International Group for the Study of Lithium-Treated Patients (www.IGSLI.org) and the Unit on the Genetic Basis of Mood and Anxiety Disorders at the National Institute of Mental Health,lithium researchers from around the world have formed the Consortium on Lithium Genetics (www.ConLiGen.org) to establish the largest sample to date for genome-wide studies of lithium response in bipolar disorder, currently comprising more than 1,200 patients characterized for response to lithium treatment. A stringent phenotype definition of response is one of the hallmarks of this collaboration. ConLiGen invites all lithium researchers to join its efforts. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

本研究結合Clark與Watson（1991）的三角模式（Tripartite Model）以及Brown、Chorpita和Barlow（1998）提出的階層性概念，結構正向情感、負向情感、焦慮、憂鬱、無望感、自傷、自殺的關係，建立自傷與自殺的階層預測模式，說明自傷與自殺的同異處。研究對象為487位大學生，325位女性與162位男性，採取自陳式問卷的方式施測，包含自我傷害行為量表、自殺危險程度量表、貝克無望感量表、正負向情感量表、症狀檢核表-90-修正版（摘錄測量焦慮與憂鬱的題目）、相關背景變項的測量，並以描述性統計、相關性考驗、階層迴歸分析、結構方程模式等統計方式對資料進行處理。主要的研究結果為：（1）負向情感能預測與解釋焦慮和憂鬱，且能透過焦慮預測自傷與自殺，唯焦慮對自傷的解釋力較高；負向情感亦能透過憂鬱預測自殺，但無法透過憂鬱預測自傷。（2）正向情感能預測與解釋憂鬱，且能透過憂鬱預測自殺。（3）加入無望感分析後，發現憂鬱能透過無望感預測自殺，憂鬱也能直接預測自殺，顯示無望感為憂鬱與自殺的部分中介變項。最後，結果發現有15.81%的自傷比例、24.64%的自殺意念比例、8.01%的自殺企圖比例。 / This study combined Clark & Watson’s (1991) tripartite model with Brown, Chorpita, and Barlow’s (1998) hierarchical model to structure the relationship of positive affect (PA), negative affect (NA), anxiety, depression, hopelessness, non-suicidal self-injury (NSSI), and suicide. This study attempted to establish hierarchical predictor model of NSSI and suicide, and explain the relationship of NSSI and suicide. The participants were 487 university students, 325 females and 162 males, who were participating in a study of test of deliberate self-harm inventory, suicide risk inventory, Beck hopelessness scale, positive and negative affect schedule, symptom checklist-90-R, and background variables. The data were examined by descriptive statistics, correlation, hierarchical analysis, and structural equation modeling. The main results were : (1) NA could predict anxiety and depression ; anxiety could not only mediate the relationship of NSSI and NA, but also mediate the relationship of NA and suicide ; anxiety accounted for more of the variance in NSSI than in suicide ; depression could mediate the relationship of NA and suicide, but could not mediate the relationship of NSSI and NA. (2) PA could predict depression, and depression could mediate the relationship of PA and suicide. (3) the role of hopelessness was partial mediator of depression and suicide. Finally, the result found 15.81% NSSI, 24.64% suicidal ideation, and 8.01% suicidal attempt.

The purpose of this study is to provide descriptions of conversations with survivors of suicide, including their relationships with the persons who committed suicide, the relationships that followed these deaths, their experiences of suicide, and the way that they made sense of these deaths. The epistemological framework of this dissertation is ecosystemic and social constructionist. This study involved in-depth interviews with three suicide survivors, exploring personal and professional domains. Thematic analysis was the method used to generate patterns of meaning. The researcher recounted the research participants' stories and punctuated emergent themes and patterns according to what she deemed important. Each story was contextualised, and included reflections of the researcher. Themes both common and unique to each participant story were highlighted and discussed. The information yielded from this study could have value to survivors of suicide and psychotherapists whose clients commit suicide. / Psychology / M.A. (Clinical Psychology)

The work deals with the aspects of the role and responsibility of a worker in helping professions at work with a client who lost their meaning of life. The work answers the questions on what sphere of knowledge the helper is supposed to have to be able to provide a high-quality and expert care. Life situations are mentioned here, which presuppose the loss of meaning of life as well as the riscs of loss of meaning of life are evaluated. Also the role and responsibility of the worker in helping profession is outlined. The work was based primarily on literature by existential-minded authors and on professional literature focused on psychology, psychiatry, social work and ethics.

No description available.

Este estudo teve como objetivo verificar as repercussões da violência por parceiro íntimo, ocorrida durante a atual gestação, na saúde mental de mulheres usuárias de um serviço de atendimento pré- natal. Trata-se de estudo observacional, com delineamento transversal, desenvolvido no Centro de Referência da Saúde da Mulher de Ribeirão Preto, São Paulo, Brasil, com 358 gestantes, em acompanhamento pré-natal no serviço, entre maio de 2012 e maio de 2013. A coleta dos dados aconteceu no dia da primeira consulta de pré-natal das gestantes no serviço, por meio de sete instrumentos: i. instrumento de caracterização sociodemográfica, econômica e comportamental; ii. instrumento de caracterização obstétrica; iii. Edinburgh Postnatal Depression Scale; iv. Post-Traumatic Stress Disorder Checklist - Civilian Version; v. Escala de Ideação Suicida de Beck; vi. Inventário de Ansiedade Traço-Estado; vii. Instrumento de identificação e caracterização da violência. Os dados foram analisados no software Statistical Package for Social Sciences, versão 21.0. Utilizamos as análises univariada, bivariada e multivariada dos dados, por meio da distribuição de frequências absolutas e relativas, medidas de tendência central e de variabilidade, os testes estatísticos Qui- quadrado e Teste t, razões de prevalência, razões de chances de prevalência, regressão logística múltipla e regressão linear múltipla. No momento da coleta dos dados, as participantes tinham, em média, 25 anos de idade e 9,5 anos de escolaridade formal. A maioria considerou-se não branca, era solteira, coabitava com o parceiro íntimo, possuía alguma religião, não exercia atividade remunerada e possuía renda familiar mensal média de 2,6 salários-mínimos, sendo o parceiro o principal provedor da família. A maioria não fumou, não consumiu bebidas alcoólicas e não fez uso de drogas ilícitas, durante a atual gestação. A amostra caracterizou-se por mulheres multigestas e nulíparas que, em sua maioria, possuíam filhos vivos e não haviam abortado. A prevalência da violência por parceiro íntimo, durante a atual gestação, foi de 17,6%. As prevalências dos indicativos das presenças de transtorno depressivo, do diagnóstico de transtorno de estresse pós-traumático e de ideação suicida foram de 28,2%, 17,0% e 7,8%, respectivamente. Os escores médios das gestantes nas escalas ansiedade-traço e ansiedade- estado foram de 39,1 e 42,5 pontos, respectivamente. Após se ajustar aos modelos de regressão logística múltipla, a violência por parceiro íntimo, durante a gestação, associou-se com o indicativo da presença de transtorno depressivo, com o indicativo do diagnóstico de transtorno de estresse pós- traumático e com o indicativo da presença de ideação suicida. Os modelos de regressão linear múltipla ajustados evidenciaram que as mulheres em situação de violência por parceiro íntimo, na atual gestação, apresentaram maiores escores dos sintomas de ansiedade-traço e estado do que aquelas que não sofreram esse tipo de violência. Portanto, reconhecer a violência como um fator de risco clinicamente relevante e identificável para a ocorrência de transtornos mentais, durante a gestação, pode ser um primeiro passo na prevenção destes problemas. Idealmente, as respostas devem incluir os setores da saúde, assistência social e justiça, no sentido de cumprir a obrigação do Estado para eliminar a violência contra a mulher / The objective of this study was to verify the repercussions of violence by the intimate partner during the present pregnancy on the mental health of women users of a prenatal care service. This is an observational study, performed with a cross-sectional design, at the Reference Center for Women\'s Health of Ribeirão Preto, São Paulo, Brazil, with 358 pregnant women following prenatal care at the referred service between May 2012 and May 2013. Data collection was performed on the day of the women\'s first prenatal appointment at the service, using seven instruments: i. instrument for sociodemographic, economic and behavioral characteristics; ii. instrument for obstetrical characteristics; iii. Edinburgh Postnatal Depression Scale; iv. Post-Traumatic Stress Disorder Checklist - Civilian Version; v. Beck Scale for Suicidal Ideation; vi. State-Trait Anxiety Inventory; vii. instrument for violence identification and characterization. The data were analyzed using Statistical Package for Social Sciences, version 21.0. Furthermore, univariate, bivariate and multivariate analyses of the data were performed, by absolute and relative frequency distribution, central and variability tendency measures, the Chi-square and T-Test statistical tests, prevalence ratio, prevalence odds ratio, multiple logistic regression and multiple linear regression. At the moment of data collection, the participants\' mean age was 25 years, and they had a mean of 9.5 years of formal education. Most women reported having the following characteristics: skin color different from white; single; living with the intimate partner; having some kind of religion; unemployed; mean monthly family income of 2.6 Brazilian minimum wages; partner was the breadwinner. Most reported not having smoked, consumed alcohol or any illicit drugs during the present pregnancy. Moreover, the sample was characterized by multiparous and nulliparous women, most of whom had living children and without a history of miscarriages. The prevalence rate for intimate partner violence during the present pregnancy was 17.6%. The prevalence rates of probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation were 28.2%, 17.0% and 7.8%, respectively. The women\'s mean scores on the trait-anxiety and state-anxiety scales were 39.1 and 42.5, respectively. After adjustment using multiple logistic regression models, associations were found between intimate partner violence during the pregnancy and probable antenatal depression, probable antenatal post-traumatic stress disorder and probable antenatal suicidal ideation. The adjusted multiple linear regression models showed that women victims of intimate partner violence in the present pregnancy had higher scores for trait-anxiety and state-anxiety symptoms compared to those who did not endure this type of violence. Therefore, recognizing violence as a clinically relevant and identifiable risk factor for the occurrence of mental disorders during pregnancy may be a first step to prevent these problems. Ideally, the answers should include the health, social work and justice domains so as to meet the duty of the Brazilian State of eliminating the violence against women

No description available.

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide. / This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Especializado Materno Perinatal, Peru for their expert technical assistance with this research. The authors would like to thank Kathy Brenner for her help with revising this manuscript. / Revisión por pares

Bakgrund: Självmord är brett representerat över hela världen och berör många miljoner människor direkt eller indirekt. Psykiatriskt sjukdomstillstånd och andra sociala och biologiska tillstånd ligger som grund då en människa tar sitt liv. Omvårdnaden vid självmordsproblematik är central och sjuksköterskors inställning och den vårdrelation som finns mellan sjuksköterska och patient är viktig vid omvårdanden av självmordsnära patienter. Syfte: Syftet med studien var att utifrån sjuksköterskor inom psykiatrisk vård och självmordsnära patienter beskriva omvårdnad som kan vara betydelsefull samt svårigheter som kan föreligga. Metod: Litteraturstudie med 12 artiklar där kvalitativ, kvantitativ och mixad metod användes. Data analyserades med Thomas och Hardens tematiska syntes. Resultat: Resultatet bildade två huvudteman; ”Förutsättningar för att bedriva ändamålsenlig omvårdnad för självmordsnära patienter” och ”Sjuksköterskors känslor – En utmaning vid omvårdnaden av självmordspatienter”. Underteman för respektive huvudteman beskriver ”Observation och säkerhet”, ”Bedömning”, ”Teamarbete”, ”Kommunikation”, ”Kunskap och stöd” samt ”Tid” och för huvudtema två ”Osäkerhet”, ”Sjuksköterskors förhållningssätt: Empati – icke empati” samt ”Medkänsla och sjuksköterskans ingjutande av hopp hos patienten”. Diskussion: Resultatet diskuteras utifrån Joyce Travelbees teoretiska utgångspunkt och belyser den unika människan och den mellanmänskliga relationen, hoppets betydelse för den lidande människan och hur vi förstår andras upplevelser genom tid och kommunikation. / Background: Suicide is widely represented all over the world and affects many millions of people directly or indirectly. Psychiatric disease states and other social and biological conditions lie as a basis when a person takes one’s life. Nursing in suicide problems is central and nurses' attitude and the care relationship between nurse and patient is important in nursing suicidal thinking patients. Aim: The purpose of the study was to describe nursing care that may be significant as well as difficulties that may exist from nurses in psychiatric care and suicidal patients. Method: Literature review with 12 articles using qualitative, quantitative and mixed methodology. Data was analyzed by Thomas and Hardens thematic synthesis. Results: The result formed two main themes; "Prerequisites for proper care for suicidal patients" and "Nursing feelings – A challenge in nursing of suicide patients". Subtopics for the respective main themes describes "Observation and Security", "Assessment", "Teamwork", "Communication", "Knowledge and Support" and "Time" and for the main theme two "Uncertainty", "Nurse’s approach: Empathy - Empathy" and "Compassion and nurse’s initiation of hope for the patient". Discussions: The result is discussed based on Joyce Travelbee's theoretical theory and highlighting the unique human and interpersonal relationship, the significance of the hope for the suffering person, and how we understand the experiences of others through time and communication.

(in English): The topic of my thesis is the suicidal tendencies of elderly people. The topic is examined from the point of view of crisis hotlines. I describe terms such as old age, telephone crisis intervention and basic developmental needs (Pesso Boyden System Psychomotor) in the theoretical part. The following practical part focuses on crisis hotlines in the Czech Republic and their statistics concerning suicidal calls. The next part of the research is the analyses of interviews with social workers working on crisis hotlines and the analyses of notes from the talks with suicidal clients. I propose different instruments for the prevention of the suicidal tendencies of elderly people in the discussion.