Biomedical subjects

H M Aro

Publications and source records attributed to H M Aro.

29 records · Page 2Linked to original sources

PubMed1994

Suicide in major depression.

OBJECTIVE: The purpose of this study was to examine a sample representing all suicide victims with current DSM-III-R major depression in Finland within 1 year in aspects relevant to suicide prevention, including comorbidity, clinical history, current treatment, suicide methods, and communication of suicide intent. METHOD: Using the psychological autopsy method, the authors examined all 71 suicide victims with current unipolar DSM-III-R major depression, taken from a random sample of 229 subjects representing 16.4% of all suicide victims in Finland in 1 year. RESULTS: The majority (85%) were complicated cases with comorbid diagnoses, and comorbidity varied according to the subjects' sex and age. Three-quarters had a history of psychiatric treatment, but only 45% were receiving psychiatric treatment at the time of death. Most suicide victims had received no treatment for depression. Only 3% had received antidepressants in adequate doses, 7% weekly psychotherapy, and 3% ECT. None of the 24 psychotic subjects had received adequate psychopharmacological treatment. Few (8%) had used an antidepressant overdose as a suicide method. Men had received less treatment for depression and had more commonly used violent suicide methods. CONCLUSIONS: Although about half of the suicide victims with major depression were receiving psychiatric care at the time of death, few were receiving adequate treatment for depression. There were significant sex differences in current and previous treatment and suicide methods. For suicide prevention in major depression, it would seem crucial to improve treatment and follow-up, for males with major depression, in particular.

Adolescent↗

PubMed1994

Suicide in bipolar disorder in Finland.

OBJECTIVE: The authors examined suicides of persons with bipolar disorder in aspects relevant to suicide prevention, including clinical features, treatment contacts, adequacy of treatment received, communication of suicidal intent, and suicide methods. METHODS: All suicide victims with DSM-III-R bipolar I disorder among all 1,397 suicides in Finland within a 12-month period were carefully studied using the psychological autopsy method and were compared to suicide victims with unipolar major depression. RESULTS: Thirty-one bipolar I victims were identified. Most suicides of persons with bipolar disorder occurred during a major depressive episode (79%), but in some cases it occurred during a mixed state (11%) or even during or immediately after remission of psychotic mania (11%). Men had a higher rate of comorbid alcoholism, a lesser mean age, and shorter treatment histories than women. Although 74% of the victims were receiving psychiatric care at the time of suicide, and 39% had even explicitly communicated their intent to health care personnel during the last 3 months, only 11% of those who were depressed had received adequate doses of antidepressants and none had received ECT. Only 32% of the bipolar patients were prescribed lithium. In comparison to unipolar depressed suicide victims, the bipolar victims had more divorces, longer treatment histories, and more frequent hospitalizations. CONCLUSIONS: Although late suicides were common among both male and female bipolar victims, suicide seemed to occur earlier among males. Most bipolar victims had had a recent psychiatric treatment contact, but few had received adequate treatment immediately before death. Suicide victims with unipolar and bipolar disorders differed in marital status and treatment history.

Adult↗

PubMed1994

Suicide in major depression in different treatment settings.

BACKGROUND: Whether suicide victims having suffered from major depression differ in their characteristics and treatment of depression received in various settings prior to death has been unknown. METHOD: From a random sample representing all completed suicides in Finland within a 12-month period, cases with a best estimate diagnosis of current unipolar DSM-III-R major depression (N = 71) were comprehensively analyzed using the method of psychological autopsy. Suicide victims with major depression were classified according to treatment setting, and the victims in different settings--psychiatric care (N = 32), medical care (N = 27), and no contact with health care (N = 12)--were compared. RESULTS: The sex distribution of suicides who had major depression was equal within psychiatric care; but in medical care or without contact with health care, 77% (30 of 39) were men (p = .018). Significantly more victims in psychiatric than in medical care had communicated to attending personnel their intent to commit suicide (59% [19 of 32] vs. 19% [5 of 27], p = .004). Antidepressants were received by 60% of victims in psychiatric care but only 16% in medical care (p = .002). CONCLUSION: Suicide victims with major depression differ in sex distribution and communication of suicide intent among treatment settings, which may complicate the ability to generalize research findings, particularly from psychiatric to medical care. Promoting suicide prevention in major depressive disorders would seem to require improving not only the quality of treatment within psychiatric care, but also basic skills in recognizing and treating depression in medical care, especially for male patients.

Age Distribution↗

PubMed1993

Precipitant stressors in adolescent suicide.

OBJECTIVE: Precipitant stressors in adolescent (aged 13 to 19 years) suicides (N = 53) were investigated in a nationwide psychological autopsy study in Finland. METHOD: Data were collected through interviews with the victims' parents and health care personnel, and from official records. RESULTS: Precipitants during the month preceding suicide were found in 70% of the cases. Almost half the precipitants occurred during the last 24 hours. Interpersonal separations and conflicts were the most common precipitants. Compared with other suicide victims, those with weakened parental support more often had interpersonal separation as a precipitant, a higher number of stressors during the final month, and had more often experienced major stress during the year before suicide. CONCLUSION: The findings highlight the importance of stress (acute, chronic, or both) in adolescent suicide. Interpersonal problems were common precipitants in adolescent suicide. Among adolescents with weakened parental support, interpersonal separations were especially common precipitants. Additional research on precipitants in adolescent suicide is needed with proper control subjects.

Adolescent↗

PubMed1993

Mental disorders and comorbidity in suicide.

OBJECTIVE: The purpose of this study was to investigate the prevalence and comorbidity of current mental disorders defined by DSM-III-R among a random sample of suicide victims from a nationwide suicide population. METHOD: Using a psychological autopsy method, the authors collected comprehensive data on all suicide victims in Finland during 1 year. Retrospective axis I-III consensus diagnoses were assigned to 229 (172 male, 57 female) victims. RESULTS: One or more diagnoses on axis I were made for 93% of the victims. The most prevalent disorders were depressive disorders (59%) and alcohol dependence or abuse (43%). The prevalence of major depression was higher among females (46%) than among males (26%). Alcohol dependence was more common among the males (39% versus 18% for females). A diagnosis on axis II was made for 31% and at least one diagnosis on axis III for 46% of the cases. Only 12% of the victims received one axis I diagnosis without any comorbidity. CONCLUSIONS: The majority of suicide victims suffered from comorbid mental disorders. Comorbidity needs to be taken into account when analyzing the relationship between suicide and mental disorders and in planning treatment strategies for suicide prevention in clinical practice.

Adolescent↗

PubMed1993

Adolescent development and youth suicide.

The adolescent years, being a period of unique developmental changes, are of great interest in understanding suicidal behavior. The occurrence of completed suicide by age in 1-year age groups in adolescence and young adulthood was studied via official Finnish mortality statistics and the population statistics. Suicide rates increased sharply by age during adolescence, starting somewhat earlier among boys than among girls. During the periods of rapidly rising and high suicide rates in the 1970s and 1980s among boys, the increase in suicide rates started at a younger age than during a spell of lower rates in the 1960s.

Adolescent↗

PubMed1992

Parental divorce, adolescence, and transition to young adulthood: a follow-up study.

In a long-term study of the effects of divorce, children in a Finnish town who had completed questionnaires in school at age 16 were followed up with postal questionnaires at age 22. Depression in young adulthood was found to be slightly more common among children from divorced families. In addition, the life trajectories of children in divorced families revealed more stressful paths and more distress in both adolescence and young adulthood.

Achievement↗

PubMed1992

Adolescent suicide: endpoint of long-term difficulties.

Characteristics of adolescent suicide victims (N = 53) were investigated in a nationwide study of suicides in Finland. The data were collected through interviews with the victims' parents and attending health care personnel and from official records. Four victims in 10 had shown antisocial behavior. One-third of the adolescents had previous suicide attempts, and 6 in 10 were known to have verbalized their suicidal thoughts. One-third of the victims had been in contact with a psychiatric care system. The results suggest that most adolescent suicides are an endpoint of long-term difficulties, and all suicidal tendencies among adolescents should be taken seriously.

Adaptation, Psychological↗

PubMed1992

Trends in suicide rates among military conscripts.

The purpose of this study was to analyse the trends in suicide rates among conscripts in Finland and to compare them with suicide rates in men of the same age in the general population. The suicide rates among conscripts slightly increased from the mid-1960s until the mid-1970s, but this rise was less marked than among young men in the population as a whole. In the 1970s and 1980s, the suicide mortality among conscripts was half of that among civilian men of the same age in the population. The implications for suicide prevention are discussed.

Adolescent↗

PubMed1991

Mental disorders in adolescent suicide. DSM-III-R axes I and II diagnoses in suicides among 13- to 19-year-olds in Finland.

The prevalence of mental disorders (DSM-III-R Axes I and II) among adolescent suicide victims (n = 53) was investigated in a nationwide psychological autopsy study in Finland. The data were collected comprehensively through interviews of the victims' relatives and attending health care personnel and from official records. Following independent assessment by two psychiatrists, the DSM-III-R diagnoses were assigned in consensus meetings. A large majority of the victims (94%) suffered from a mental disorder. The most prevalent disorders were depressive disorders (51%) and alcohol abuse or dependence (26%). The prevalence of adjustment disorders (21%) was higher than in most studies from other countries. Personality disorder was diagnosed in 32% of the cases. Comorbidity was found in 51% of the victims. The results indicate a strong relatedness between adolescent suicide and the presence of depression, antisocial behavior, and alcohol abuse.

Adolescent↗

PubMedDate not supplied

Paternal remarriage as a modifier of proneness to depression in young adulthood.

BACKGROUND: The remarriage of a parent is a major event experienced by many children. Its role in children's depressive symptoms was examined in a follow-up study of a cohort from the age of 16 to 22 years. METHODS: The study population consisted of young people who had experienced parental divorce in childhood (N=356). Associations between a parent's remarriage and potential modifying factors in adolescence (atmosphere at home, school performance, dating behavior, life-events, the importance of siblings, and socioeconomic status) and depressive symptoms at 22 years of age were studied. RESULTS: A poor atmosphere at home at 16 years and father's remarriage (but not mother's) in childhood were associated with subsequent depression. Girls whose father had not remarried, but boys whose father had remarried, were more depressive than others. Dating behavior in adolescence modified proneness to depression in these groups. CONCLUSION: The findings indicate the importance of the father in adolescent development after divorce and that the processes involved may differ by gender.

Adolescent↗