Reducing risk of suicide: advice & resources for relatives, friends, health professionals & those at risk
Last updated on 13th February 2013
Here are half a dozen recent research studies - two on aspects of mindfulness, two on sobering prevalence rates, one on imagery in health anxiety, and one on CBT with children. Fuller details, links and abstracts for all studies are listed further down this page. Willem Kuyken and colleagues looked at "How does mindfulness-based cognitive therapy (MBCT) work?" in helping recurrent depression sufferers. They came up with some fascinating and provocative findings. For example it appears that MBCT acts differently from standard CBT, although they are both helpful in reducing risk of depressive relapse. Standard CBT (and maintenance antidepressants too) reduce cognitive reactivity to experiences of induced low mood, and this appears important in how they lessen relapse risk. MBCT however seems to act not by reducing cognitive reactivity so much as by decoupling the reactivity from a tendency then to slide into depression. It appears this decoupling is mediate
Here are seven recent papers on panic, attention training, and the effects of childhood sexual abuse (all details & abstracts to these studies are listed further down this blog post). Pfaltz & colleagues report on a novel ambulatory respiratory monitoring system that seems to demonstrate that panic sufferers are not routinely suffering from breathing abnormalities (e.g. hyperventilation) when they go about their daily lives. The CBT theory of panic disorder would go along with this - panic being seen as due, in part, to catastrophizing about the meaning of experienced physical sensations rather than due to simply having unusual physical sensations. Shelby et al's paper extends this understanding concluding that with sufferers from non-cardiac chest pain (NCCP) "Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing.
Here are half a dozen recent research papers on depression (all details & abstracts to these studies are given further down this blog posting). Yonkers et al's publication is a very welcome one - "The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists." At last here's a major review giving good advice on this extremely important subject. To learn more it's worth getting hold of a copy of the complete text. You may have access to this through your academic department. If not, authors are usually happy to send a PDF via email when asked to - emails can be dug out via a little Google detective work. Following the [Abstract/Full Text] link will also provide various access routes including a low-cost patient information option. In further work looking at depression
Here are half a dozen studies on the long-term effects of various forms of abuse & deprivation. Paras et al systematically reviewed the association between a history of sexual abuse and a lifetime diagnosis of a somatic disorder. They found significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain. When analysis was restricted to studies where sexual abuse was defined as rape, they also found an association with fibromyalgia. Abstracts and links, for this research paper and the further papers described, can be found lower down this page.
Here are half a dozen papers relevant to psychotherapy. The first two throw some light on the question of whether it matters which form of established psychotherapy one uses to treat a particular depression sufferer - bearing in mind Cuijpers et al's recent meta-analysis suggesting that " ...
Here are a couple of studies on the prevalence of depression and anxiety, and four on risk factors for depression, bipolar disorder and suicide. Strine et al report on a major survey of depression and anxiety in the United States. They found "The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%-13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%-21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%-17.2%)." Smoking, lack of exercise, and excessive drinking were all associated with increased likelihood of mental disorders, as too was physical ill health. Young et al, in a separate study, looked at the likelihood of depression and anxiety becoming persistent. They estimated - at nearly 3 year follow-up - that the US prevalence of persistent depressive or anxiety disorder was 4.7%. Only about a quarter of these sufferers were using appropriate medication and only about a fifth appropriate counselling.
Five of these six studies are from last month's American Journal of Psychiatry. Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial. Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery. Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful. Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system. Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.
Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455. [Abstract/Full Text]
6.15am and I'm sitting in front of my computer. Berg's violin concerto is playing on Radio 3 (it's through their "listen again" feature).