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Biomedical subjects

L Mehlum

Publications and source records attributed to L Mehlum.

At least 19 recordsLinked to original sources
PubMed2001

[Psychosocial follow up after parasuicide at hospital departments in Norway].

BACKGROUND: Routines and standards of care for parasuicide patients in general hospitals in Norway were reviewed in relation to international and national recommendations. MATERIAL AND METHODS: Telephone interviews were conducted with personnel at all Norwegian general hospitals with emergency units. 55 of a total of 58 hospitals participated (95%). RESULTS: Two thirds of the hospitals reported that most parasuicide patients were routinely psychiatrically evaluated and then referred to psychiatric or community aftercare. At almost half of the hospitals (46%) the staff had not received any specific training in clinical management of parasuicide patients during the last three years. Structured collaboration with external aftercare providers was non-existent in 43% of the hospitals. Hospitals with projects aimed at psychosocial follow up of parasuicide patients or hospitals with a team or a person responsible for the follow-up, had, however, routines more in accordance with the recommendations than hospitals without projects or teams. INTERPRETATION: The study shows great variations between Norwegian general hospitals in their routines and standards of care for psychosocial follow-up of parasuicide patients. Increasing the staff's competence, developing written routines and establishing mutually binding co-operation between the hospital and external caregivers are important areas for further development.

Emergency Service, Hospital↗
PubMed1999

Alcohol and stress in Norwegian United Nations peacekeepers.

Peacekeepers are frequently exposed to dangerous, provoking, or humiliating situations and have limited possibilities to express the resulting anger and frustrations. Self-medication with alcohol and drugs to calm down may result. A representative sample (N = 888) of Norwegian United Nations veterans who served in South Lebanon completed a questionnaire regarding service-related stress and the role of alcohol in stress management. A total of 43.5% of the respondents reported that they had increased their consumption of alcohol during the mission. Overall, only a minority gave reasons such as tension, restlessness, anxiety, and stress to explain the increase. Respondents who had been exposed to the highest levels of stress, however, reported significantly more frequently these potentially pathological reasons for increased drinking. To prevent such outcomes, personnel need to be screened for risk reactions and to be educated in alternative stress management measures. Furthermore, management of both stress and the destructive use of alcohol is clearly a leadership issue.

Adaptation, Psychological↗
PubMed1998

[Prevention of suicide among young people--recent experiences from the armed forces].

Each year about 70% of all 19-year old males are enlisted to the Norwegian Armed Forces. The rapid rise in the number of suicides among young people will therefore inevitably be reflected among conscripts. Studies of epidemiology and risk factors have led to the development of a specific suicide prevention programme which includes educational, leadership and welfare elements, as well as efforts initiated through the military health care service. In addition, an emergency telephone service is available 24 hours a day. This suicide prevention programme, which has its origins in the military chain of command rather than the medical service, has so far been very well received and implemented throughout the Armed Forces.

Adult↗
PubMed1998

Suicidal ideation and sense of coherence in male conscripts.

Antonovsky's Sense of Coherence (SOC) scale, reflecting a dispositional orientation which, according to theory, is associated with coping and resiliency, was highlighted in a study focusing on the association between stressful life events and the development of suicidal ideation and behaviour in the young. During their first stressful week of basic training, 663 male Norwegian conscripts answered a questionnaire focusing on their lifetime and current suicidal ideation and behaviour. The lifetime prevalence of suicidal ideation and attempted suicide was 21.7% and 2.6%, respectively. Suicide ideators and attempters had on average significantly lower SOC scores compared to respondents with no suicidal ideation or behaviour. Furthermore, a stepwise multiple regression analysis revealed SOC to be a good predictor of current suicidal ideation in this non-clinical population, accounting for 21% of the total variance.

Adaptation, Psychological↗
PubMed1996

[Suicidal process and suicidal motives. Suicide illustrated by the art, life and illness of Vincent van Gogh].

A suicide will naturally be a shock to the surroundings, unexpected and brutal as it is. Suicide survivors will often emphasize the unexpected. Nevertheless a suicide must be regarded as the end result of a long process. In this paper the extremely well-documented case of Vincent van Gogh is used to study suicidal processes and suicidal motives. In van Gogh's case, an early childhood trauma initiated a life-long suicidal process. His difficulties as regards attachment to and separation from his parents continued throughout his life and his emotional instability, intensity and lowered tolerance to frustration seem to portray a borderline personality. Vincent van Gogh's chronic suicidal ideation and behaviour led to a series of crises throughout his life, escalating during the last 18 months before his suicide in 1890. It is possible to identify at least three prominent suicidal motives in van Gogh's case. The first is unbearable emotional pain related to personal experience of loss which reactivated the childhood trauma. The second is introverted murderous rage arising from conflicts with other persons. The third motive described is the need for a cathartic release of energy and emotion.

France↗
PubMed1994

The longitudinal pattern of suicidal behaviour in borderline personality disorder: a prospective follow-up study.

The aim was to study the longitudinal course of suicidal behaviour and ideation in patients with borderline personality disorder (BPD) compared with patients with other diagnoses. Ninety-seven patients (41 BPD, 33 other personality disorders, 23 no personality disorder) consecutively admitted to a day unit were given a prospective personal interview follow-up with evaluations at admission, discharge and at follow-up after 2-5 years. Even when controlled for Axis I disorders, BPD patients showed significantly more often a lifetime history of suicide attempts. BPD patients with a history of suicide attempts were more suicidal at index admission, continued to be so over the follow-up period and differed systematically in an unfavourable direction from other BPD patients on the major outcome measures. BPD patients without suicidal behaviour had an outcome nearly as good as non-BPD patients, and only 41% of them retained the BPD diagnosis at follow-up. Suicidal behaviour and ideation are highly prevalent in BPD. These suicidal expressions are of an enduring nature and seem as a diagnostic criterion to enhance the predictive capacity of the BPD diagnosis.

Adult↗
PubMed1994

Young male suicide attempters 20 years later: the suicide mortality rate.

In a 20-year, register-based follow-up of a group of 51 young male conscripts who had made a suicide attempt during their service, 2 were found to have committed suicide during the follow-up period. These figures gave a 20-year accumulated suicide mortality of 3.92%, whereas the corresponding value in the cohort of Norwegian males who reached the age of 20 in the period 1968-1972 was 0.40%. In spite of this clear difference, the study indicates that the long-term suicide mortality is relatively low for young suicide-attempters in this type of setting compared to figures from other follow-up studies.

Adolescent↗
PubMed1993

[Suicide among inpatients in Gaustad Hospital 1954-1991].

We present results from a retrospective study of 31 suicides committed during the years 1954-1991 among inpatients at Gaustad Hospital. There was a radical increase in the suicide rate during the period, an increase that was higher than expected from the increase among the general population. The patients suffered from serious psychopathological conditions. Hanging was found to be the most frequent method of suicide, reflecting that psychiatric inpatients use methods that are easily available. Changes in the routines for admission, discharge and treatment of patients are discussed as possible factors explaining the increase. Improved evaluation of risk of suicide, more active antipsychotic and antidepressive treatment and improved control when risk of suicide is assessed to be high are discussed as important prophylactic measures.

Adult↗
PubMed1992

Prodromal signs and precipitating factors in attempted suicide.

What characterizes the presuicidal phase of suicide attempters in a military population? And what precipitates their suicidal action? These questions were investigated in a sample of 112 male suicide-attempting conscripts serving in the Norwegian Armed Forces. One-half of the subjects had shown behavioral signs such as isolation or aggression, over 80% displayed psychiatric symptoms. A majority verbally expressed their psychic problems, but few had explicitly stated suicidal ideas. Two major clusters of suicide precipitants were identified. Loss traumas were recorded in one-third of cases, some sort of conflict situation in 40% of cases. Implications for suicide preventive measures are discussed.

Adolescent↗
PubMed1991

[Attempted suicide among Norwegian soldiers. A retrospective study].

Suicidal behaviour is a rapidly increasing health problem among young men, and represents a major challenge to the Armed Forces. A retrospective investigation of suicide attempts among male conscripts showed that even though the overall incidence is lower than in civilian settings it is high among the basic trainees. The suicide-attempting soldier often has a troublesome background, with psychiatric disorders and drug or alcohol abuse. Many have personality disorders, and a subgroup displays repeated self-destructive behaviour. Most soldiers employ less life-threatening self-destructive methods and attempt the suicide on military premises. Many are influenced by alcohol. Following the suicide attempt most soldiers are quickly discharged from service. The paper discusses various aspects of self-destructive behaviour among soldiers and possible preventive measures.

Adult↗
PubMed1991

Personality disorders 2-5 years after treatment: a prospective follow-up study.

Ninety-seven patients consecutively admitted to a day unit specializing in the treatment of personality disorders were included in a prospective follow-up study. At follow-up an average of 3 years after index admission, patients with borderline personality disorder (BPD) displayed a moderate symptom reduction and a fair global outcome. Patients with schizotypal personality disorder (STP) showed a similar reduction in symptoms but retained relatively poor global functioning. Individuals with cluster C personality disorders, in contrast, showed both a good global outcome and a marked symptom reduction. STP individuals were the least socially adjusted, employed and self-supporting of all diagnostic subgroups. STP and BPD individuals had far more inpatient treatment in the follow-up period than other groups. The overall suicide rate was low compared with most similar studies.

Adult↗
PubMed1990

Attempted suicide in the armed forces: a retrospective study of Norwegian conscripts.

In the easily surveyable and rather homogeneous military population of the Norwegian Armed Forces, a group of 112 male suicide-attempting conscripts was studied retrospectively. Compared to a normal conscript population, suicide attempters more often had troublesome backgrounds, had experienced psychiatric problems and abuse, and had previously more often attempted suicide. Diagnostically adjustment disorders, alcohol and drug abuse, and personality disorders predominated, whereas major affective disorders and psychotic disorders were rare. Methods of self-destruction employed were mostly drug ingestion and laceration. Personality disordered subjects tended to have lower suicidal intent than others.

Adolescent↗