Suicide behaviour of patients treated with antidepressants.
Rihmer Z. & Gonda X.
Neuropsychopharmacol Hung. 2006 Mar;8(1):13-6.
Although antidepressants undoubtedly treat depression and decrease suicidality in case of severely ill depressives in the case of good clinical response, there is evidence that antidepressants can worsen depression and can increase suicidality in a very small subpopulation. Some individual case histories were published that of SSRIs can induce suicidal behaviour, mainly at the beginning of the treatment, during akathisia, restlessness and agitation. Some clinical trials suggested that provocation of suicidality could be a serious side-effect of antidepressants. The almost double frequency of suicidal behaviour of patients on antidepressants compared to patients on placebo; it is in sharp contrast with the 2-6 fold lower suicide risk of antidepressant treatment versus untreated patients.
http://www.mppt.hu/pdf/0601_OK2.pdf
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[Suicidal behavior in adolescents--psychopathology and addictive comorbidity] [Article in Hungarian]
Voros V, Fekete S, Hewitt A, Osvath P.
Neuropsychopharmacol Hung. 2005 Jun;7(2):66-71.
Despite of the decreasing suicide rates, the number of suicide attempts--peculiarly in the adolescent population--shows a growing tendency. Due to the small amount of study results the problem remains hard to assess. Child and Adolescent Self harm in Europe (CASE) study, allows us to explore self-reported suicidal behavior among adolescents more exactly. This European multicentre study has a special focus on adolescent suicidal behavior (suicidal thoughts, ideation, deliberate self harm, suicide attempt) and other self destructive behavior (drug, alcohol) as well as psychopathological symptoms (anxiety, depression, impulsivity, aggression) and it also investigates coping strategies, life events and family background. In the representative school-based community study an anonymous, self-reported questionnaire were conducted with 4408 (males: 2388, females: 2020) 15 and 16 year-old pupils. Out of the 4408 pupils 7.8% (males: 4.6%, females: 11.6%) of the adolescents reported former suicide attempt, 1.6% of the boys and 3.6% of the girls reported about more than one suicide attempts. According to the statistical analysis the suicidal group greatly differs from the non-suicidal one. Suicidal adolescents were more likely to use alcohol, drugs or nicotine than their non-suicidal peers. Drug abuse was four times more common among suicidal boys, and five times more common among suicidal girls than in the non-suicidal group. 30% of the boys and 13% of the girls used more than one kind of drug. The use of ecstasy and sedatohypnotic drugs showed the most spectacular difference between suicidal and non-suicidal teenagers in both genders. Suicide attempters usually had higher scores in scales measuring anxiety, depression, impulsivity, while their self-esteem was significantly lower. The comparative analysis has revealed that suicide attempters compose a subgroup with more severe psychopathology (anxiety, depression, and impulsivity), lower self-esteem and ineffective coping strategies. Suicidal behavior frequently appeared with addictive problems. The results of our study may help in recognizing the role of risk factors coexisting with suicidal behavior and thus making it easier for schools to have adequate and effective prevention programs.
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Suicide prevention strategies--a brief review.
Zoltán Rihmer, Zsuzsa Kántor, Annamária Rihmer, Krisztina Seregi
Neuropsychopharmacol Hung. 2004 Dec;6(4):195-9.
Since suicide is a very complex, multicausal human behaviour, its prevention should also be complex. The prediction of suicide is very difficult at the level of the general population, but it is much easier among patients with certain mental disorders, because most persons who kill themselves have diagnosable and treatable psychiatric disorders. This article reviews the most important biological and non-biological suicide prevention strategies.
http://www.mppt.hu/pdf/0404_KOZL3.pdf
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[Gender differences in suicidal behavior] [Article in Hungarian]
Voros V, Osvath P, Fekete S.
Neuropsychopharmacol Hung. 2004 Jun;6(2):65-71.
Gender-specific differences in suicidal behaviour have been analysed in a number of recent studies. According to these, several socioeconomic, demographic, psychiatric, familial, help-seeking differences can be identified in protective and risk factors between males and females. Gender is one of the most replicated predictors for suicide. In the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour, more than fifty thousand suicide attempts have been registered so far. Until now data on more than 1200 monitored suicidal events have been collected in Pecs centre. In most countries male suicid rates are higher. In contrast to suicides, rates of suicide attempts are usually higher in females. Concerning the differences in methods, it is a recognised fact that males use violent methods of both suicide and attempted suicide more often than females. The summarised clinical impression suggests that compliance of male patients is poorer than that of females. According to our data, a typical male attempter is characterised as follows: unemployed, never married, lives alone. He tends to use violent methods; if he takes drugs, it is mostly meprobamate or carbamazepine. A lot of male attempters have alcohol problems or dependence. As for the females, we found high odds ratios in the following cases: divorced or widowed, economically inactive, depressive state in the anamnesis. Female attempters are mainly repeaters using the method of self-poisoning, mostly with benzodiazepines. As suicide is a multicausal phenomenon, its therapy and prevention should also be complex and gender differences should be taken into account in building up our helping strategies.