Magazine article Clinical Psychiatry News

Clinical Capsules

Magazine article Clinical Psychiatry News

Clinical Capsules

Article excerpt

Suicide Prevention Program

A suicide prevention program implemented in the U.S. Air Force has been well received and successful during its first 6 years of operation, reported Kerry L. Knox, Ph.D., of the University of Rochester (N.Y.) and her colleagues.

The relative risk of suicide declined by a significant 33% during 1997-2002 in a dynamic cohort of more than 5.2 million Air Force personnel (84% male) who were on active duty at some point during 1990-2002. The relative risk of accidental death, homicide, and moderate and severe family violence declined by amounts ranging from 18% to 54%.

The Air Force developed 11 initiatives that targeted "strengthening social support, promoting development of effective coping skills, and changing policies and norms so as to encourage effective help seeking behaviors" (BMJ 327[7428]:1376-78, 2003).

Traumatic Brain Injury

Sufferers of traumatic brain injury have a significantly higher rate of major depression than patients who had traumatic injuries outside of the central nervous system, reported Dr. Ricardo E. Jorge and his associates at the University of Iowa, Iowa City.

Of 91 consecutive patients with closed head injuries, 30 presented with major depressive features; half of these patients had major depression at an initial evaluation and half had the disorder after 3 or 6 months of follow-up. Compared with 44 nondepressed traumatic brain injury (TBI) patients, depressed TBI patients were significantly more likely to have a personal history of mood disorders (11.4% vs. 36.7%) and anxiety disorders (4.6% vs. 20%) (Arch. Gen. Psychiatry 61[1]:42-50, 2004).

A significantly greater percentage of depressed TBI patients had an anxiety disorder (23 of 30) than did nondepressed TBI patients (9 of 44). Aggressive behavior was seen in significantly more of the depressed patients (17 of 30) than the nondepressed patients (10 of 44).

Seventeen patients were excluded because they developed mania or subsyndromal depression.

Antidepressant-Related Deaths

Selective serotonin reuptake inhibitors are implicated in suicide and accidental deaths when used in combination with other drugs, especially tricyclic antidepressants, reported Survjit Cheeta, Ph.D., and colleagues at the University of London.

In a study of 468 antidepressant-related deaths in England and Wales during 1998-2000, selective serotonin reuptake inhibitors (SSRIs) were associated with significantly fewer intentional and accidental deaths (2 per million prescriptions) than would be expected when standardized for the number of prescriptions (Br. …

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