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Biomedical subjects

C R Pfeffer

Publications and source records attributed to C R Pfeffer.

At least 37 records · Page 2Linked to original sources
PubMed1994

Suicidal children grow up: suicidal behavior and psychiatric disorders among relatives.

OBJECTIVE: This paper reports comprehensive data on psychiatric symptoms and disorders and medical problems of first- and second-degree biological relatives of prepubertal children who have contemplated or attempted suicide. METHOD: Standard family study and family history interview techniques were used to obtain information about psychopathology and medical illness in 488 first- and 1,062 second-degree relatives of 25 child psychiatric inpatients who reported suicide attempts, 28 child psychiatric inpatients who contemplated suicide, 16 nonsuicidal child inpatients, and 54 normal children. RESULTS: Suicidal behavior in children was associated with suicidal behavior in their families, although no first-degree relatives committed suicide. More first-degree relatives of child suicide attempters, compared to first-degree relatives of normal children, had antisocial personality disorder, assaultive behavior, and substance abuse. Mood disorders in first-degree relatives were not associated with child suicidal behavior. No significant associations were identified for psychopathology of second-degree relatives and child suicidal behavior. CONCLUSIONS: The results suggest the importance of evaluating familial psychopathology during assessments of suicidal children. Self-directed and externally directed violence, antisocial personality disorder, and substance abuse of relatives of suicidal children should be studied to elucidate the etiology of youth suicidal behavior.

Adolescent↗
PubMed1993

Suicidal children grow up: rates and psychosocial risk factors for suicide attempts during follow-up.

OBJECTIVE: Rates and psychosocial risk factors for suicide attempts during a 6 to 8-year follow-up period were compared for 25 predominantly prepubertal inpatient suicide attempters, 28 inpatient suicidal ideators, 16 nonsuicidal inpatients, and 64 nonpatients. METHOD: Standard research instruments were used to interview subjects and parents. Cox proportional hazard regression analyses were used to identify risk factors for a suicide attempt in the follow-up. RESULTS: No deaths occurred during follow-up. Suicide attempters were six times and suicidal ideators were three times more likely than were nonpatients to attempt suicide during follow-up. Poor social adjustment and mood disorder close to a recurrent suicide attempt were the strongest risk factors. CONCLUSIONS: Risk assessment should focus on identifying symptoms of mood disorders and impaired social adjustment in children with histories of suicide attempts and psychiatric hospitalization.

Adolescent↗
PubMed1992

Suicidal children grow up: psychiatric treatment during follow-up period.

This study compares the treatment course during a 6- to 8-year follow-up period of 53 suicidal preadolescent and young adolescent psychiatric inpatients with those of 16 nonsuicidal psychiatric inpatients and 64 nonpatients selected from a community. The three groups of subjects were matched on demographic characteristics. All 69 patients and 10 (15.6%) nonpatients received treatment during follow-up. Treatment course during follow-up for suicidal patients was significantly longer, earlier, and more intensive than for the nonpatient controls. Fifty-five percent of 20 subjects who attempted suicide during follow-up were in treatment at the time of the suicide attempt.

Adolescent↗
PubMed1991

Suicidal behavior and hypothalamic-pituitary-adrenocortical axis indices in child psychiatric inpatients.

Studies of adults have reported associations between suicidal behavior and hypothalamic-pituitary-adrenocortical (HPA) axis functioning, but these associations were inconsistent. Very few studies of prepubertal children evaluating these relations exist. This study of 49 prepubertal psychiatric inpatients evaluates associations between suicidal behavior and predexamethasone and postdexamethasone plasma cortisol levels shortly after hospital admission and 7 weeks later. Results suggest that associations between suicidal behavior and plasma cortisol levels are independent of diagnosis. Covariation of predexamethasone and postdexamethasone plasma cortisol levels with major depression was associated with severity of suicidal behavior. Implications of these results for childhood suicidal risk are discussed.

Child↗
PubMed1991

Suicidal children grow up: demographic and clinical risk factors for adolescent suicide attempts.

This longitudinal study reports rates and demographic and clinical risk factors for adolescent suicide attempts during a 6- to 8-year follow-up period of an initial sample of 106 preadolescent and young adolescent psychiatric inpatients and 101 preadolescent and young adolescent nonpatients. Survival analysis was used to evaluate risk for a first suicide attempt in the follow-up period for 133 subjects who were interviewed. No deaths occurred. Suicidal inpatients, compared with nonpatients, had earlier first suicide attempts in the follow-up period. Adolescents who attempted suicide in the follow-up period were seven times more likely to have a mood disorder during the follow-up period than those who did not attempt suicide. Implications for clinical practice and research are discussed.

Adolescent↗
PubMed1991

Suicide in Japan.

Explore the source record for details and available documents.

Cross-Cultural Comparison↗
PubMed1990

Sequelae of bereavement resulting from suicide.

Although clinical experience suggests that individuals who have been bereaved as a result of suicide may be especially vulnerable to adverse sequelae, such as unusually severe grief or increased risk of committing suicide themselves, the idea that this type of bereavement is special has received only limited systematic investigation. The authors review the literature on the subject, with special attention to the clinical and research evidence about whether bereavement resulting from suicide is different from bereavement due to other types of death, and make suggestions for further clinical and epidemiological research on this question.

Bereavement↗
PubMed1989

Psychopathology and plasma cortisol responses to dexamethasone in prepubertal psychiatric inpatients.

This study of 51 prepubertal psychiatric inpatients evaluates plasma cortisol measurements at 8 AM, 4 PM, and 11 PM before and after dexamethasone was administered in counterbalanced order at doses of 0.5 mg and 1.0 mg. Approximately 76.5% of the children had an affective disorder. Major depressive disorder was associated with higher plasma cortisol levels than other disorders. Pre- and postdexamethasone plasma cortisol levels using 0.5 mg dexamethasone exhibited a circadian variation. The optimal criterion for cortisol nonsuppression was 5 micrograms/dl measured at 8 AM after administration of 0.5 mg dexamethasone.

Child↗
PubMed1989

An abused psychotic preadolescent at risk for Huntington's disease.

An abused 10-year-old girl with a family history of Huntington's disease developed incapacitating abdominal pain with concomitant behavioral symptomatology suggestive of dementia. The pseudoneurologic nature of her symptoms was clarified through exhaustive evaluation and did not appear to be that of early-onset Huntington's disease. Assessment included pediatric, psychiatric, neurologic, and gynecologic examination; extensive radiologic and laboratory tests; and chronobiology studies. Successful treatment necessitated the integration of numerous therapeutic modalities including dynamically oriented psychotherapy, psychopharmacologic intervention, physical therapy, behavior modification, and electroconvulsive therapy.

Abdomen↗
PubMed1989

Subtypes of suicidal and assaultive behaviors in adolescent psychiatric inpatients: a research note.

Among 129 adolescent psychiatric inpatients, four subgroups of suicidal and/or assaultive behaviors were identified. A suicidal-only subgroup with no evidence of assaultive behavior was characterized by depression, drug abuse and environmental stresses. An assaultive-only subgroup with no evidence of suicidal behavior exhibited aggressive symptoms and violence at home. A subgroup with both suicidal and assaultive behaviors experienced accidents and family violence. A fourth subgroup had neither suicidal nor assaultive behavior. This subgroup showed eating disorders, depression, minimal assaultiveness and few peer friendships.

Adolescent↗
PubMed1989

Changes in suicidal behavior in child psychiatric inpatients.

This study of 49 preadolescent psychiatric inpatients, aged 6-12 years, evaluated changes from the time of admission to 7 weeks later in ratings of suicidal behavior, assaultive behavior, depression, hopelessness, and global functioning. Standard research instruments were used to measure these variables. There were significant decreases in suicidal behavior, assaultiveness, and depression and a significant increase in global assessment during the 7 weeks of hospitalization. Severity of suicidal behavior and severity of assaultive behavior at admission predicted a subsequent change in level of suicidal behavior. Furthermore, severity of suicidal behavior at admission was the best indicator of a change in severity of suicidal behavior.

Anxiety, Separation↗
PubMed1989

Assessment of suicidal children and adolescents.

This article describes approaches to assessment of suicidal youth. Of paramount concern is that a clinician have up-to-date knowledge obtained from reports of empirical studies about the factors associated with suicidal risk in children and adolescents. These factors, which are outlined in this article, involve psychiatric, biologic, psychosocial, and sociocultural variables.

Adolescent↗