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Biomedical subjects

M Alsén

Publications and source records attributed to M Alsén.

10 recordsLinked to original sources

Self-poisonings with drugs by adolescents in the Lund catchment area.

Our objective was to investigate which drugs young people who attempt suicide use in the Lund catchment area-eight municipalities in Skåne, southern Sweden. All patients aged up to 18 years admitted to Lund University Hospital after deliberate or probably deliberate self-poisoning from 1 January 1991 until 31 December 1995 were included. Forty-nine (58%) had used a single drug; 20 (24%) had used 3 or more drugs. Fifty-two (61%) used analgesics-paracetamol was used by 38 (45%) and propoxyphene by 17 (20%). Thirty-one (36%) had ingested psychotropics-13 used benzodiazepines, 10 antidepressants, and 8 antipsychotics. Eleven (15%) had used drugs in combination with alcohol. We conclude that it is important to follow changes in self-poisoning patterns, to monitor the effects of preventive work and discover new trends in drug use.

Adolescent↗

The suicide assessment scale: an instrument assessing suicide risk of suicide attempters.

The Suicide Assessment Scale (SUAS), a scale constructed to measure suicidality over time, was administered to 191 suicide attempters. Its predictive validity was tested. SUAS ratings were compared to ratings from other scales, and related to age and psychiatric diagnoses including co-morbidity. Eight patients committed suicide within 12 months after the SUAS assessment. Apart from advanced age, high scores in the SUAS were significant predictors of suicide. From a receiver operating characteristic (ROC) analysis, we identified cutoff SUAS scores which alone and in combination with certain diagnostic and demographic factors are of apparent value in the clinical evaluation of suicide risk after a suicide attempt.

Adolescent↗

Changes of cerebrospinal fluid monoamine metabolites during long-term antidepressant treatment.

This study describes the changes in cerebrospinal fluid (CSF) monoamine metabolites during antidepressant treatment for more than 6 months. Eight patients, who received antidepressant treatment after attempted suicide and then underwent lumbar punctures every 3 or 4 months, were included. Plasma drug concentrations and the clinical outcome were also measured. Consistent with previous reports about antidepressant treatment for between 3 and 6 weeks, both 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA) were significantly decreased after treatment for a mean of 15 weeks compared to pretreatment. However, after continued treatment for a mean of 30 weeks the MHPG concentration remained significantly lower than at pretreatment while 5-HIAA had returned to the pretreatment level. The clinical outcome was significantly correlated to the pretreatment 5-HIAA/MHPG ratio. These results suggest that the frequently reported reduction in CSF 5-HIAA after antidepressant treatment does not remain during long-term treatment.

Adult↗

Hopelessness and suicidal behavior.

The main purpose of this study was to investigate the relationship of the Beck Hopelessness Scale (BHS) with suicidal behavior and other clinical variables in 212 hospitalized suicide attempters. Another purpose was to analyze the usefulness of BHS in this particular context. Those who later committed suicide (N = 13) had significantly higher median scores than those who did not. Even though the median BHS score for the total population was above the cut-off score for future suicide risk, suggested by Beck et al., the relative ratio of correctly positive/false positive was low. Therefore the BHS does not seem to be a satisfactory instrument for predicting future suicide in hospitalized suicide attempters. Our findings rather suggest that the BHS is related to depression ratings, mood disorders and/or personality disorders.

Adjustment Disorders↗

Serum lipids in suicide attempters.

As other studies have shown possible associations of low serum cholesterol concentrations as well as serotonin and corticosteroid deviances with suicide or depression, the present study was undertaken to investigate the serum lipid levels in subgroups of suicide attempters. Serum lipids were determined in 72 suicide attempters. Cerebrospinal fluid monoamine metabolites and plasma cortisol levels were measured, and dexamethasone suppression tests were performed. Hopelessness and suicidality were rated by the Hopelessness Scale (HS) and the Suicidal Intent Scales (SIS). The mean total serum cholesterol (TSC) level was 5.0 +/- 1.2 mmol/L. We found no significant correlations between TSC and the monoamine metabolites. High-density lipoprotein cholesterol showed positive correlations with the dopamine metabolite homovanillic acid (r = 0.39, p = 0.04) and the serotonin metabolite 5-hydroxyindoleacetic acid (r = 0.34, p = 0.07). The SIS and HS scales did not correlate significantly with serum lipids. "Violent" attempters showed somewhat higher serum lipid levels than "nonviolent" attempters. We found no significant differences in serum lipid levels between the diagnostic subgroups. Hence, we could not find much support for the hypothesis of associations between low cholesterol levels and decreased serotonin activity in the brain. However, this field merits further investigation.

Adolescent↗

Medicine self-poisoning and the sources of the drugs in Lund, Sweden.

The purpose of this study was to investigate the prevalence of toxic agents in attempted and completed suicides. The purpose was also to explore the sources of the drugs taken by suicide attempters. Verbal information on drug intake was collected from 280 suicide attempters during 1987-1990 in the Lund-Orup catchment area. Information on the sources of the drugs was collected from 143 of these attempters. The study also includes toxicological screening from 73 fatal poisonings in southern Sweden during 1989. According to verbal information, the most common drugs used by suicide attempters were benzodiazepines (51%), analgesics (29%) and antidepressants (20%). In suicide attempters, diazepam and levomepromazine were reported more than expected from prescription data. Toxicological screenings of fatal poisonings showed that benzodiazepines were most common (55%), followed by analgesics (38%), mainly propoxyphene (29%) and antidepressants (30%), mainly amitriptyline (22%). Amitriptyline and diazepam were more commonly detected in completed suicides than expected from prescription data. The most common sources of drugs to attempted suicides were physicians, and especially psychiatrists. We therefore conclude that continuous information to physicians on drug overdose is important, and it is also important to introduce alternative strategies to prevent suicidal behaviour.

Adolescent↗

The role of monoamines in suicidal behavior.

Cerebrospinal fluid (CSF), urine, platelet and neuroendocrine challenge tests of monoaminergic function give evidence of monoamines, especially serotonin, playing an important role in suicidal behavior. However, additional clinical, social and biochemical factors are necessary to better define suicide-prone psychiatric patients.

Biogenic Monoamines↗