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Danuta Wasserman

Publications and source records attributed to Danuta Wasserman.

29 records · Page 2Linked to original sources
PubMed2004

Trends in adolescent suicide mortality in the WHO European Region.

Trends in adolescent suicide rates (15-19 years) from 1979 to 1996 were compared with suicide trends in individuals of 20 years and over in 30 countries and with trends in rates of deaths due to undetermined causes in adolescents in 17 countries of the WHO European Region. In 21 of the 30 studied countries, male adolescent suicide rates increased during the study period (highest increases in Belarus, Kazakstan and Ireland) accompanied by far less increases or decreases in suicide rates of males of 20 years and over. Part of the observed increases in Sweden, Ireland and Greece can be attributed to improved suicide statistics, while increases in Finland, Belgium, Bulgaria and the United Kingdom can be even higher due to the rising classification of deaths as "undetermined". In Portugal, decreasing suicide trends seem to be misinterpreted by ignoring the vast increases in rates of undetermined deaths. Female adolescent suicide rates rose less markedly than in males in 18 countries, with the exception of strong increases in Norway, Ireland. Increases in female adolescent suicide rates were marginally affected by changes in classification practices and were accompanied primarily by declining suicide rates in females of 20 years and over.

Adolescent↗
PubMed2004

Psychiatric diagnoses and suicide: revisiting the evidence.

BACKGROUND: The key role of prevention and treatment of mental disorders in the prevention of suicide is widely acknowledged. Which specific disorders need to be targeted remains to be conclusively demonstrated. AIMS: To re-examine the presence of psychiatric diagnosis in cases of completed suicide from a global perspective. METHOD: A review of studies reporting diagnoses of mental disorders in cases of completed suicide with or without history of admission to mental hospitals. RESULTS: Most cases were from Europe and North America (82.2%). The majority (98%) of these had a diagnosis of at least one mental disorder. Among all diagnoses, mood disorders accounted for 30.2%, followed by substance-use related disorders (17.6%), schizophrenia (14.1%), and personality disorders (13.0%). CONCLUSIONS: The mental health paradigm in suicide prevention covers just a part of the problem. Antisuicide strategies focusing exclusively on the identification and treatment of depression need to be reconsidered. In addition to this, other mental disorders should be targeted, in particular alcohol-use disorders and schizophrenia. More emphasis should also be placed on psychosocial and environmental interventions diminishing and counteracting stress.

Europe↗
PubMed2004

Suicide-preventive activities in psychiatric care: evaluation of an educational programme in suicide prevention.

To promote implementation of suicide-preventive activities, the Swedish National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) introduced a 200-h academic, postgraduate educational programme (based on the training-of-trainers model) in suicide prevention. This programme was provided at Karolinska Institute, Stockholm, for key persons in psychiatric care. Twenty-nine key persons from 11 psychiatric intervention clinics in Stockholm County attended the first course. Preconditions for implementing suicide-preventive activities were assessed by means of semi-structured interviews with all course participants still working in the intervention clinics (n=10). In all but one of these 10 clinics, a wide range of suicide-preventive activities had been implemented as a result of the NASP course. Activities varied in scope, but the key persons seemed to have succeeded in pinpointing the key elements in suicide prevention - the need for specific knowledge about the suicidal process and for well-defined suicide-preventive routines. However, organizational factors and staff turnover were obstacles to maintaining and making the activities routine. There is a need to strengthen the course participants' formal roles as implementers and encourage the clinical management in their continuous implementation of suicide-preventive activities.

Adult↗
PubMed2004

Depression, anxiety, and psychological defense in attempted suicide: a pilot study using PORT.

Depressive affect, anxiety, and psychological defenses were studied in the presented research with PORT, a projective test that exploits subliminal perception of object-relation images. Protocols of 20 hospitalized suicide attempters were compared to those of 20 matched controls, 34 previously studied nonsuicidal depressed patients, 18 patients with panic attack, and 32 patients with borderline and psychotic disorders. The suicide attempters were anxious; their defenses resembled those seen in borderline pathology; depressive reactions were limited in symbolic content; reality testing was poor. The closeness between depression and anxiety in suicidality is further discussed throughout this article. A constellation of signs using the PORT test was hypothesized to be a marker for suicidality. The test is deemed useful for future research on suicide.

Journal Article↗
PubMed2004

Benefits of implementing an academic training of trainers program to promote knowledge and clarity in work with psychiatric suicidal patients.

A 200-hour academic, postgraduate training-of-trainers program in suicide prevention at Karolinska Institute for key mental healthcare staff, designed to enable them to enhance their co-workers' knowledge and job clarity, was evaluated in a panel study by means of questionnaires. Psychiatric staff working regularly with suicidal patients in clinics where key persons attended the course (n = 134, intervention group) were compared with staff working in clinics without participants (n = 166, control group). Perceptions of being sufficiently trained (p < .01) improved significantly among staff working in intervention clinics. Compared with the control group, the intervention group had a better understanding of essentials (p < .05); found instructions clearer (p < .01) and experienced fewer problems with superiors' differing views (p < .05) at follow up. Assistant nurses working in intervention clinics seem to have benefited most.

Journal Article↗
PubMed2003

The roles of knowledge and supervision in work with suicidal patients.

Despite caregivers' impact on suicidal patients' compliance with treatment and suicide prevention, little is known about mental-health professionals' perceptions of work with suicidal patients. The roles of psychiatric staff's training and supervision in the care of suicidal patients were investigated by means of a postal questionnaire sent to a random sample of 1543 psychiatric staff members. The response rates were 71% for psychiatrists and 57% for nurses and assistant nurses. The responses of 53 psychiatrists, 164 nurses and 333 assistant nurses working with suicidal patients on a regular basis were compared and analysed using the Kruskal-Wallis test. Thirty-five per cent of the assistant nurses, 43% of the nurses and 74% of the psychiatrists who worked with suicidal patients on a regular basis perceived that they were sufficiently trained for this work, while 75% of the assistant nurses, 72% of the nurses and 34% of the psychiatrists received supervision in their work with suicidal patients. In spite of receiving supervision, nursing staff who perceived that they lacked training reported uncertainties in their work with suicidal patients to a larger extent than those who perceived that their training was sufficient. Uncertainties were significantly more prevalent among nursing staff than among psychiatrists. Basic and specific training in suicidology is needed and cannot be replaced solely by supervision, since psychiatric staff often have to deal with suicidal patients in emergency situations and must be able to rely on their own skills.

Analysis of Variance↗
PubMed2002

Why people engage in parasuicide: a cross-cultural study of intentions.

Information obtained at interview from 1,646 parasuicide patients in 14 regions in 13 European countries participating in the WHO/EURO Multicentre Study on Suicidal Behaviour was used to study self-reported intentions involved in parasuicide. Comparisons were made across cultures, genders, and age groups. Although some statistically significant differences were found, the effect sizes were very small. The main finding from this study is thus that parasuicide patients in different countries tend to indicate that similar types of intentions are involved in their acts of parasuicide, and that the intentions do not vary greatly with gender or age. The hypothesis that rates of suicide and parasuicide vary between regions with the frequency with which suicidal intention is indicated by the patients was also tested, but was supported only for women and in relation to national suicide rates. The findings from this study are likely to be generalizable to other settings and have implications for clinical practice.

Adolescent↗