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| 2. |
- Niméus, Anders, et al.
(författare)
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Evaluation of a modified interview version and of a self-rating version of the Suicide Assessment Scale.
- 2006
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Ingår i: European Psychiatry. - : Cambridge University Press (CUP). - 1778-3585 .- 0924-9338. ; 21:7, s. 471-477
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Tidskriftsartikel (refereegranskat)abstract
- The Suicide Assessment Scale (SUAS) was constructed to be sensitive to change of suicidality. It was recently found to be predictive of suicide in a group of suicide attempters. The aim of the present study was to evaluate the reliability and validity of a modified interview version of SUAS with defined scores and also a new self-rating version (SUAS-S). The subjects consisted of former inpatients, 42 persons who had been admitted because of a suicide attempt about 12 years ago and 22 control patients. The subjects were rated according to the SUAS, the SUAS-S, as well as the Montgomery Asberg Depression Rating Scale (MADRS). The interrater reliability was found to be high. The SUAS correlated significantly with the MADRS, but the concordance was not consistent, which indicates that the SUAS measures something different from depression. The SUAS-S correlated significantly with the interview-rated SUAS, thus exhibiting good concurrent validity. In summary, both the modified interview version of SUAS and the SUAS-S seem to be valid, reliable and easily used suicide assessment instruments. (c) 2006 Elsevier Masson SAS. All rights reserved.
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| 3. |
- Sunnqvist, Charlotta
(författare)
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LIFE EVENTS, STRESS AND COPING
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In order to increase the understanding of suicidal behaviour, the general aim of the thesis is to gain a profound knowledge of the suicidal individual, and hence to find and ensure a preventive strategy. This will be accomplished by finding and trying new methods for evaluation of suicide risk. The Suicide Assessments Scale, SUAS, and a new self-rating version, SUAS-S were tested. These scales are sensitive to change of suicidality over time, and both of them seem to be valid and reliable suicide rating scales, which might aid the clinician in the assessment of suicide risk. A time-geographic life charting was invented and tested. This model promotes systematic descriptions of the patient’s life events (social and burdensome) over time, and geographical sites are used as anchors for autobiographical memories. A so called lifeline follows each individual and provides information on the person’s social capacity, as well as information on predisposing, stressful or precipitating life events. Vulnerability for adverse life events by measuring biological stress markers among suicide attempters was tested. High catecholaminergic markers in CSF (MHPG) and urine (NA/A) were found in suicide attempters, who had been sexually abused in childhood, and we found low urine-cortisol in suicide attempters who felt neglected by parents during childhood and adolescence. A variety of factors have been identified as being risk factors for suicidal behaviour, and one of them is the handling of stressful events (coping). The coping-strategies used by suicide attempters and comparison groups were investigated. Suicide attempters at long term follow up and healthy controls used more adaptive problem solving strategies than patients, who had recently made a suicide attempt, or psychiatric controls, who both used more maladaptive coping strategies. A person’s suicidal intent is often difficult to understand, so therefore an investigation of a time geographic life charting, in combination with a survey of coping capacities during life, and degree of suicidality (SUAS-S) by the time of a suicide attempt, was made. The combination of these methods offered a firm and comprehensive picture of the patient’s life situation, which in our opinion, facilitates an assessment of suicidal intent. By using multidisciplinary methods, ranging from biological investigations to psychosocial as well as environmental approaches, we suggest three typical pathways to a suicide attempt, the first where the involved persons mainly use adaptive coping and rate low scores on the SUAS-S, the second where both maladaptive and adaptive coping are used, and where the SUAS-S scores are on a moderate level, and third where maladaptive coping is the common way of handling stressful events, and where SUAS-S scores are high.
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| 4. |
- Sunnqvist, Charlotta, et al.
(författare)
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Suicide attempters :biological stressmarkers and adverse life events
- 2008
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Ingår i: European Archives of Psychiatry and Clinical Neuroscience. - : EAPCN. - 0940-1334 .- 1433-8491. ; 258:8, s. 456-462
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Tidskriftsartikel (refereegranskat)abstract
- Risk factors for suicidal behaviour include adverse life events as well as biochemical parameters acting, e.g. within the hypothalamic–pituitary– adrenal axis and/or monoaminergic systems. The aim of the present investigation was to study stressful life events and biological stress markers among former psychiatric inpatients, who were followed up 12 years after an index suicide attempt. At the time of the index suicide attempt, and before treatment, cerebrospinal fluid (CSF) samples were taken, and 24 h (h) urine (U) was collected. 3-Methoxy-4-hydroxyphenylglycole (MHPG) in CSF and 24 h urinary samples of cortisol and noradrenaline/adrenaline (NA/A) were analysed. Data concerning stressful life events were collected retrospectively from all participants in the study through semi-structured interviews at follow-up. We found that patients who reported sexual abuse during childhood and adolescence had significantly higher levels of CSF-MHPG and U-NA/A, than those who had not. Low 24 h U-cortisol was associated with feelings of neglect during childhood and adolescence. In conclusion, this study has shown significant and discrepant biological stress-system findings in relation to some adverse life events.
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| 5. |
- Sunnqvist, Charlotta, et al.
(författare)
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Time geography: a model for psychiatric life charting?
- 2007
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 14:3, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- Since many years, life charting has been used to describe the life course and life events of psychiatric patients. The aim of the present study was to describe and evaluate time geographic life. charts of 11 former psychiatric patients in order to promote systematic descriptions of their life events over time. Information on all events which was gathered from the life charts was analysed by manifest content analysis and reduced to four categories: information received by asking only about moves, social capacity, predisposing life events and/or stressful as well as precipitating life events. Our findings showed that this kind of life charts offered a comprehensive and structured picture. They describe a detailed life situation from one time period to another, where geographical sites serve as anchors. The patients expressed satisfaction with this method of combining an interview with a time geographic life line.
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| 6. |
- Vang, Fredrik, et al.
(författare)
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Life-time adversities, reported thirteen years after a suicide attempt: relationship to recovery, 5HTTLPR genotype, and past and present morbidity.
- 2009
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Ingår i: Archives of Suicide Research. - : Informa UK Limited. - 1543-6136 .- 1381-1118. ; 13:3, s. 214-229
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we investigated how adversities related to past and present morbidity, and genotype. Forty-two, suicide attempters and 22 matched control patients were followed-up after 13 years. Life-time adversities were explored in an interview, and the patients were reassessed psychiatrically. The serotonin-transporter-linked promotor region (5-HTTLPR) was typed. More adversities were reported by suicide attempters than controls, and by still-ill than recovered suicide attempters. Adversities reported at follow-up were related to psychiatric morbidity at follow-up, but not to morbidity 13 years earlier. The 5-HTTLPR, genotype was associated with reported adversities, but not chances of recovery. Adversities potentially affected chronic morbidity. 5-HTTLPR genotype did not affect long-term recovery.
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| 7. |
- Westling, Sofie, et al.
(författare)
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Altered glucose tolerance in women with deliberate self-harm
- 2009
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Ingår i: Psychoneuroendocrinology. - : Science direct. - 0306-4530 .- 1873-3360. ; 36:6, s. 878-883
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Tidskriftsartikel (refereegranskat)abstract
- Disturbances in glucose metabolism are of importance for violent behaviour in men, but studies in women are lacking. We used the 5 h-oral glucose tolerance test (OGTT) in this study of 17 female psychiatric patients, selected for violent behaviour directed against themselves (deliberate self-harm) and 17 healthy controls matched for age and BMI. Following OGTT, patients had higher glucose levels at 30 min (p = 0.007) and increased glucagon area under the curve (p = 0.011). Since a co-morbid eating disorder might affect results, we as a post-hoc analysis subgrouped the patients and found that the increased glucagon levels only were present in patients with an eating disorder. In contrast, those without an eating disorder showed a significantly lower p-glucose nadir (p = 0.015) and unaltered glucagon levels compared to controls. There were no significant differences in insulin and C-peptide levels between patients and controls. We conclude that deliberate self-harm in women may be associated with alterations in carbohydrate metabolism in certain groups. Eating disorder is a confounding factor.
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