| 1. |
- Bergqvist, Erik, et al.
(author)
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Health care utilisation two years prior to suicide in Sweden: a retrospective explorative study based on medical records
- 2022
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
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Journal article (peer-reviewed)abstract
- Objective Previous literature has suggested that identifying putative differences in health care seeking patterns before death by suicide depending on age and gender may facilitate more targeted suicide preventive approaches. The aim of this study is to map health care utilisation among individuals in the two years prior to suicide in Sweden in 2015 and to examine possible age and gender differences. Methods Design: A retrospective explorative study with a medical record review covering the two years preceding suicide. Setting: All health care units located in 20 of Sweden's 21 regions. Participants: All individuals residing in participating regions who died by suicide during 2015 (n = 949). Results Almost 74% were in contact with a health care provider during the 3 months prior to suicide, and 60% within 4 weeks. Overall health care utilisation during the last month of life did not differ between age groups. However, a higher proportion of younger individuals (< 65 years) were in contact with psychiatric services, and a higher proportion of older individuals (>= 65 years) were in contact with primary and specialised somatic health care. The proportion of women with any type of health care contact during the observation period was larger than the corresponding proportion of men, although no gender difference was found among primary and specialised somatic health care users within four weeks and three months respectively prior to suicide. Conclusion Care utilisation before suicide varied by gender and age. Female suicide decedents seem to utilise health care to a larger extent than male decedents in the two years preceding death, except for the non-psychiatric services in closer proximity to death. Older adults seem to predominantly use non-psychiatric services, while younger individuals seek psychiatric services to a larger extent.
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| 2. |
- Cato, Ville, et al.
(author)
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Association between benzodiazepines and suicide risk : a matched case-control study
- 2019
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In: BMC Psychiatry. - : BMC. - 1471-244X. ; 19:1
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Journal article (peer-reviewed)abstract
- Background: It is unclear whether benzodiazepines increase the risk of suicide. The aim of this study was to test the hypothesis that benzodiazepines are associated with an increased risk of suicide, by comparing psychopharmacological interventions between psychiatric patients who committed suicide and a group of matched controls.Methods: The case group comprised 154 psychiatric patients (101 men, 53 women; age range: 13-96 years) who had committed suicide in orebro County, Sweden. Control psychiatric patients matched by age, sex, and main psychiatric diagnosis were selected for each case. Binary logistic regression was used to calculate odds ratios in unadjusted and adjusted models.Results: Benzodiazepine prescriptions were more common among cases than controls (65/154 [42.2%] versus 43/154 [27.9%], p = 0.009, odds ratio: 1.89 [95% CI: 1.17-3.03]). This association remained significant in a model adjusted for previous suicide attempts and somatic hospitalizations (odds ratio: 1.83 [95% CI: 1.06-3.14]). No statistically significant differences were seen between the groups in the use of any other subtype of psychopharmaceutical agent.Conclusions: These data indicate that benzodiazepine use may increase the risk of suicide. However, this study is limited by the potential for indication bias.
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| 3. |
- Engström, Ingemar, 1952-, et al.
(author)
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Adolescents' Experiences of the Staff's Different Interaction Styles in Coercive Youth Care in Sweden : A Qualitative Study
- 2020
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In: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 41:11, s. 1027-1037
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Journal article (peer-reviewed)abstract
- We interviewed 20 adolescents who were coercively placed in residential or psychiatric care. The aim was to explore their views on the way staff relate and perform their duties, favorable characteristics in staff, consequences of different treatment from staff and their safety experiences. Thematic analysis identified the following themes: Situational triggers of frustration; Care-based; rule-based; or passive-avoidant interaction styles toward adolescents and their responses; Adolescents' reflections about staff's interaction styles; and the Consequences on the unit atmosphere depending on different interaction styles toward the adolescents. Adolescents preferred staff who showed them respect and a clear wish to make life easier.
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| 4. |
- Holländare, Fredrik, 1972-, et al.
(author)
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Are quantity and content of psychiatric interventions associated with suicide? : A case-control study of a Swedish sample
- 2020
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In: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 20:1, s. 1-11
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Journal article (peer-reviewed)abstract
- Background Research is required to identify those psychiatric interventions with a protective effect against suicide. The overarching aim of the current study was to examine whether completed suicide in psychiatric patients in a Swedish population was associated with the quantity and nature of previous medical and psychosocial treatment interventions. Methods This retrospective case-control study (n = 308) compared a group of deceased psychiatric patients with matched controls. For every case of suicide, a control was found within psychiatry that matched according to sex, age, and primary psychiatric diagnosis. A stepwise forward logistic regression model with suicide as the dependent outcome variable was used. Results Receiving pharmacotherapy combined with psychotherapy [OR: 0.44 (95% CI: 0.226-0.876), p = 0.019] and a higher number of outpatient visits in psychiatry [OR: 0.99 (95% CI: 0.982-0.999), p = 0.028] were negatively associated with suicide. These associations were still significant after controlling for previous serious suicide attempts and somatic comorbidity. Conclusions Frequent visits and pharmacotherapy combined with psychotherapy seem to be important for preventing suicide in psychiatric patients. The reasons for not receiving such therapy are important issues for further study.
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| 5. |
- Lundqvist, Lars-Olov, 1958-, et al.
(author)
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Influence of mental health service provision on the perceived quality of life among psychiatric outpatients : associations and mediating factors
- 2024
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In: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 14
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Journal article (peer-reviewed)abstract
- Objective To investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.Methods A total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients' perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.Results Variables in mental health service provision showed few direct associations with patients' perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (chi 2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).Conclusion This study shows that mental health service provision is associated with patients' perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients' QoL.
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| 6. |
- Rytterström, Patrik, et al.
(author)
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Finding the Silent Message : Nurses’ Experiences of Non-Verbal Communication Preceding a Suicide
- 2019
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In: Psychology. - : Scientific Research Publishing. - 2152-7180 .- 2152-7199. ; 10:1, s. 1-18
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Journal article (peer-reviewed)abstract
- Suicidal individuals often communicate their intention to commit suicide, but not necessarily verbally. Psychiatric nurses play a central role in the care of patients exhibiting suicidal behaviour or thoughts. Thus, the aim of this study was to explore nurses’ experiences of the indirect messages about forthcoming suicide from patients’ everyday life before they committed suicide. A qualitative design was used with a phenomenological hermeneutical approach. Seven nurses working in specialist psychiatric care were interviewed about their experience of the phenomenon communication about suicide. Results show how the nurses noticed changes in patients just before they committed suicide. These changes included rapid improvement, disguise of real feelings, and unreceptiveness to further treatment or encouragements. The nurses also described patients becoming aware of painful life conditions of losing hope and confidence in the future and experiencing feelings of powerlessness or an inability to influence the situation. Their last moments were characterised by a greater preoccupation with thoughts about death and finding ways to express farewells. This manifested itself in practical preparations and expressing gratitude to people, which was understood by the nurses as a way of saying goodbye. This study shows that it is possible for skilled staff to develop an understanding of a suicidal patient’s internal state and to recognise the non-verbal messages of someone who later committed suicide. The knowledge of how patients prepare and act before suicide could be used to complement a structural suicide risk assessment.
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| 7. |
- Schückher, Fides, 1956-, et al.
(author)
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History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
- 2019
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In: BMC Women's Health. - : BMC. - 1472-6874. ; 19:1
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Journal article (peer-reviewed)abstract
- Background: To examine the relationship between treatment outcome, as measured according to change in alcohol consumption, and a history of childhood abuse (emotional, physical, sexual) in socially stable women undergoing treatment for alcohol use disorder (AUD).Methods: Participants were assessed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview at the beginning of treatment (n = 75), end of treatment (n = 59) and 12 month follow-up after treatment (n = 57). Self-report data on alcohol consumption were obtained at all three time-points using the Alcohol Habits Inventory-Revised 2. Self-report data on childhood maltreatment were obtained at the beginning of treatment using the Childhood Trauma Questionnaire-short form. Study outcomes were changes in alcohol consumption (grams of pure alcohol per week), risk-drinking and reported abstinence.Results: Of the 75 women enrolled, 38 (50.7%) reported a history of childhood abuse and the rest did not. Both groups showed a significant improvement in all three outcomes at the end of treatment and at 12-month follow-up. At the end of treatment, a significant inter-group difference was found for reported abstinence (non-abused group, 39.3% vs abused, 12.9%; p < 0.05). At 12-month follow-up, significant inter-group differences were observed for all treatment outcomes, with superior outcomes being found for the non-abused group, including a higher proportion of women with reported abstinence (55.6% vs 13.3%; p < 0.01).Conclusion: The present findings suggest that an evaluation of a possible history of childhood abuse is warranted in all women seeking treatment for AUD, irrespective of social stability. In terms of clinical practice, the results suggest that additional interventions may be warranted in this population.
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| 8. |
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| 9. |
- Schückher, Fides, 1956-, et al.
(author)
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Predictors for Abstinence in Socially Stable Women Receiving Treatment for Alcohol Use Disorder
- 2022
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In: Alcoholism Treatment Quarterly. - : Informa UK Limited. - 0734-7324 .- 1544-4538. ; 40:2, s. 244-257
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Journal article (peer-reviewed)abstract
- There is a knowledge gap about predictors of treatment outcomes in alcohol use disorder (AUD) in socially stable women. This study examined factors that may predict abstinence 12 months after the end of treatment for AUD in socially stable women. Fifty-seven women with AUD participated in 12-month follow-up. Information about sociodemographic, alcohol-related, psychiatric symptoms, psychological functioning, and participants' treatment goals and ability to change alcohol habits were gathered from structured interviews and self-report instruments. Predictors for abstinence at the 12-month follow up were calculated by univariable and multivariable logistic regression models. Significant predictors for abstinence were having no history of childhood abuse (OR: 8.13; 95%CI: 2.22-29.75; p < .01) and a goal of abstinence at the end of treatment (OR: 15.17; 95%CI: 3.45-66.69; p < .001). Most participants (>60%) achieved their goals of abstinence or low-risk drinking. The results highlight the significance of identifying patients with experiences of childhood abuse, since such experiences may adversely affect the outcome of AUD treatment. Our findings also emphasize the importance of patients' own goals of abstinence, since it resulted in the most stable outcome. Treatment could, therefore, also focus on motivating individuals to aim for abstinence.
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| 10. |
- Schückher, Fides, 1956-, et al.
(author)
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The Impact of Childhood Maltreatment on Age of Onset of Alcohol Use Disorder in Women
- 2018
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In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 24:6, s. 278-285
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Journal article (peer-reviewed)abstract
- It is unclear whether exposure to childhood maltreatment is associated with the age of onset of alcohol use disorder (AUD). A group of socially stable women with AUD seeking treatment (n = 75) were interviewed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview. They also filled out the Childhood Trauma Questionnaire-short form. Emotional abuse, sexual abuse and multiple childhood traumas were found to be associated with earlier onset of AUD. Multivariable linear regression analysis showed that independent predictors for an earlier onset of AUD were exposure to emotional abuse (beta = -7.44, SE = 2.83, adjusted p = 0.010) and mother's alcohol/substance problems (beta = -7.87, SE = 3.45, adjusted p = 0.026). These variables explained 18.9% of the variance of age of onset of AUD. These findings highlight a need for increased clinical attention to AUD subgroups who have experienced childhood maltreatment, especially emotional abuse, as well as a need for including support in the patient's own parental role in the treatment. (C) 2018 S. Karger AG, Basel
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