Suicide and the Predictions of Suicide.

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        Suicide and the Predictions of Suicide

Diane Poulos

Abnormal Psychology

4-17-04

In the first paper I read about hopelessness and eventual suicide, four authors studied 207 hospitalized patients with suicidal ideation. There was a follow up period of 5-10 years when these patients were systematically checked up on to see their status. Fourteen eventually completed suicide within the follow up period. In the study the researchers used the Beck Depression Inventory, the Hopelessness Scale, and the Scale of Suicidal Ideation. The only tools that eventually predicted the suicides were the Hopelessness Scale and the pessimism items on the Beck Depression Inventory. This study is to prove the importance of hopelessness as an indicator of eventual suicide. Another study proved the extremity of suicidal attempts is more correlated with hopelessness than depression. Hopelessness seems to be more correlated with suicide in patients with alcohol and drug abusers. To run the experiment, researchers administered the self rating scale and the standardized assessment as soon as the patient was willing and ready to take them. After being released from the hospital, the 5-10 year follow up program begin to make certain whether the patient was alive or dead at each contact. Out of the 207 people in the study, 14 definitely committed suicide. There we not other differences in their background characteristics. The only difference was seen in the Hopelessness Scale. This shows the correlation of hopelessness to eventual suicide among ideation.

The next paper I read is controlled prospective study called Clinical Predictors of Suicide in Patients with Major Affective Disorders. This was written by six authors who collected data that shows the difference between 25 suicide completers and 929 non completers out of 954 patients with Major Affective Disorder. Their follow up period was about four years. Eight of the suicide occurred within the first 6 months and the other thirteen within a year.  Retrospective studies of suicide have shown that suicide occurs with a diagnosis of a psychiatric disorder like depression, schizophrenia, or alcoholism. The authors claim that all except the prospective studies of Beck and Motto have one problem in common and that is that they do not recognize the difference between suicide completers and attempters. Retrospective studies allow for researchers to see the differences between the two groups and therefore eliminating this problem. The limitations of these studies are that no "true" control group can be formed and no description of the psychopathology can be made complete like prospective studies. In this study the sample was 599 patients with uni-polar depression, 175 with bipolar type 1 affective disorder, 92 with bipolar type 2 affective disorder, and 88 with schizoaffective disorder. The number of completed suicides is relatively small which can affect the significance of the findings to other populations. There are a few problems with this study. The prospective set up limits the number of completers available for comparison with the surveying patients and the because they are comparing the completers with the entire sample of patients with Major Affective Disorder, the chance of false positives inflate to above .05.  Hopelessness, loss of pleasure or interest, fewer previous episodes in the suicide group, mood cycling during the index episode, and loss of reactivity were seen in the completers. A history of fewer adolescent friendships discriminated the suicide group as well. The cycling of mood during the index episode is the only affective subtype significantly associated with suicide. Age and sex did not differentiate the groups, but a slight higher rate in suicide for never married people was detected in this study, but not for other marital statuses. 463 of the total sample had previously attempted suicide. 17 of them died in the study, and 8 without suicide history died. This study showed that a suicide is most likely to occur 6-12 months after hospital discharge. This study also showed the importance of the Hopelessness Scores. It shows the loss of reactivity as being associated with completers and this is consistent with the findings of loss and interest. The SADs item of depressive turmoil showed up in 4 of the 25 suicide patients, but only 13 of the entire 954. This shows trends with more dissatisfaction with life, social withdrawal, alcohol abuse, drug abuse, and loss of work role function as consistent, yet not significant.

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The third paper I read is a collaborative Depression Study. It talks about Dexamethasone and its suppression in suicide. The Dexamethasone suppression test is a measure of hyperactivity of the hypothalmicpituitary-adrenal axis. Seventy eight inpatients with major depressive disorder or schizophrenia depressed type participated in this study. The patients were given a DST test and then began a long 15 year follow up period to check their status. There were thirty two abnormal DST results out of the seventy eight subjects. They were diagnosed and followed up with by interviewers periodically.  The DST testing was not part of the ...

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