Acta psychiatrica Scandinavica
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Acta Psychiatr Scand · Aug 1990
Comparative StudyA psychiatric study of suicide among urban Swedish women.
A total of 104 suicides among women were investigated by means of a modified psychological autopsy, including interviews with survivors and a review of somatic and psychiatric records. Diagnosis according to Research Diagnostic Criteria (RDC) showed that 35% were suffering from a major depressive disorder during their final month and another 24% were also depressed; 12% were substance abusers and 14% had adjustment disorders. Two thirds had attempted suicide and another 23% had communicated suicidality in other ways. ⋯ Fifty-seven percent had been psychiatric inpatients or outpatients during the final year of life. An increasing number of life events occurred during the final 6 months. In most cases the depressed women had been treated ineffectively with antidepressant drugs.
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Acta Psychiatr Scand · Aug 1990
From community mental health services to specialized psychiatry: the effects of a change in policy on patient accessibility and care utilization.
In 1975, a community mental health (CMH) centre with most of its resources channelled to outpatient services was set up in a defined catchment area of 75,000 inhabitants near Stockholm. In 1981, the CMH centre was allocated 3 inpatient wards of its own. An outpatient unit to treat long-term psychotic patients was also built up from existing resources. ⋯ The number of compulsory admissions increased by 20% (still being far below the mean number in Stockholm). The decrease in the patient population is attributed to the reduction in accessibility to the CMH centre at a time when primary care services in the area were undergoing a sizeable expansion. The increased care utilization is the result of an internal redistribution of resources in favour of resource-demanding, long-term psychotic patients.
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Acta Psychiatr Scand · Feb 1990
The availability of firearms and the use of firearms for suicide: a study of 20 countries.
The availability of firearms in a country was measured by noting the percentage of homicides committed using a firearm. This measure of gun availability was found to be positively associated with the suicide rate using firearms and negatively associated with the suicide rate using all other methods. The implications of these findings for suicide prevention are discussed.
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Acta Psychiatr Scand · Feb 1990
The changing pattern of suicide by gassing in Australia, 1910-1987: the role of natural gas and motor vehicles.
There have been large changes in the use of gas as a suicide method in Australia during this century, the most marked being the increased use of motor vehicle exhaust fumes, and the introduction of natural gas in the early 1960s. In males, use of motor vehicle exhaust fumes as a suicide method has substituted for use of domestic gas. It was concluded that in neither sex did the elimination of toxic carbon monoxide in domestic gas, with the introduction of natural gas, result in a lasting reduction of suicide rates. Attention is drawn to possible failed suicide attempts using motor vehicles with emission controls, resulting in serious cerebral damage.
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Acta Psychiatr Scand · Jun 1988
Dexamethasone suppression test and response to antidepressant therapy in psychogeriatric patients.
Senile dementia patients show a high incidence of abnormal Dexamethasone Suppression Test (DST) which has been suggested to reflect the presence of atypical or subclinical depression; this study was designed to test this hypothesis. Thirty-six patients, diagnosed as suffering from dementia and/or depression on the DSM-III criteria, participated in the study. They were divided into three groups. dementia (12), depression (12) and dementia with depression (12). ⋯ Demented patients who had clinical depression also showed a poor response. The response to treatment was unrelated to the DST status of the patients. It is concluded that abnormal DST in dementia patients is not indicative of a masked affective state, and antidepressants have no place in the management of dementia patients who have a positive DST but no overt affective symptoms.