Biomedical subjects

M M Henriksson

Publications and source records attributed to M M Henriksson.

32 records · Page 2Linked to original sources

PubMed1995

Suicide among female adolescents: characteristics and comparison with males in the age group 13 to 22 years.

OBJECTIVE: To characterize female suicides (n = 19) in an unselected nationwide youth suicide population aged 13 to 22 years (n = 116) and to compare them with male suicides with respect to variables indicating psychopathology and psychosocial functioning. METHOD: The data were collected in a psychological autopsy study of all suicides (N = 1,397) in Finland during a 12-month period. Data collection included interviews of next of kin and professionals and information from records after the suicide. RESULTS: Two thirds (68%) of the female victims had suffered from a mood disorder, and 73% had communicated their suicidal intent. Half (47%) of the female subjects had been in psychiatric care at some point in their lives, and 42% had been hospitalized. Compared with young male suicides, the young female victims more often had made previous suicide attempts (63% versus 30%), received more often a diagnosis of major depression (37% versus 14%), and had more often been in psychiatric care (47% versus 21%) during the year preceding the suicide. The females were more often incapable of working, and their psychosocial impairment was more severe during the final week. Alcohol abuse was almost as common among the female as the male victims (21% versus 26%). CONCLUSION: The results suggest that young females who commit suicide may have suffered from more severe psychopathology than young male victims. Substance abuse seems to be a major factor also in female suicides. Preventive efforts within psychiatric care are likely to reach a higher proportion of the young females than males at high risk for suicide.

Adolescent↗

PubMed1995

Mental disorders and suicide prevention.

In the research phase of the National Suicide Prevention Project, all suicides (n = 1397) in Finland between March 1987 and April 1988 were examined retrospectively using the psychological autopsy method. Careful retrospective diagnostic evaluation of the victims according to DSM-III-R criteria was done by weighing and integrating all available information. A series of studies addressing the mental disorders among suicide victims, the treatment received before death and the life events is now reviewed. Among a random sample of suicide victims from the natiowide suicide population, at least one psychiatric diagnosis was made for 93% of the victims. The most prevalent disorders were depressive syndromes (66%) and alcohol dependence/abuse (43%). The prevalence of major depression was higher among women than among men. Major depression as the principal diagnosis was more common among the elderly suicides. Among adolescent victims, depressive syndromes were also the most prevalent disorders. Adjustment disorders were common (25%) among male adolescent suicides. The majority of suicide victims of all ages suffered from comorbid mental disorders. Among suicide victims who had had contact with a health carer before death, inadequacy of treatment for mental disorders seems to have been common. Of the major depressive victims only 3% were found to have received adequate psychopharmacological treatment, and only 7% received weekly psychotherapy by a trained therapist. The analysis of the massive database collected in the research phase of the National Suicide Prevention Project in Finland is still ongoing, and the implications of the findings for suicide prevention will be refined during the research process. The necessity to improve recognition and treatment for comorbid depressive disorders in all age groups seems evident already.

Adolescent↗

PubMed1995

The last appointment before suicide: is suicide intent communicated?

OBJECTIVE: The authors' goal was to determine whether people who committed suicide within 4 weeks after having made contact with a health care professional communicated their intent to commit suicide during that final contact. METHOD: Using data from a nationwide psychological autopsy study of all suicides in Finland that occurred in 1 year, the authors examined the 571 cases of suicide victims whose last appointment with a health care professional took place up to 28 days before suicide, including 100 cases of victims who had appointments on the day of suicide. RESULTS: Suicide intent was reportedly discussed in only 22% of the cases; it was particularly uncommon in general practice and nonpsychiatric specialist settings. CONCLUSIONS: The majority of patients who commit suicide do not seem to communicate their intent to do so during their last appointment.

Adolescent↗

PubMed1994

Psychosocial stressors more common in adolescent suicides with alcohol abuse compared with depressive adolescent suicides.

OBJECTIVE: Relationships between stressors and psychiatric diagnoses were studied among 13- to 19-year-old adolescent suicide victims with alcohol abuse/dependence (N = 14), depressive disorders (N = 18), and the remainder (N = 21). METHOD: The study included all adolescent suicides (N = 53) during a nationwide psychological autopsy study of suicides in Finland during a 12-month period (N = 1397). The data were collected through interviews with the victims' parents and health care personnel and from official records. RESULTS: Interpersonal separations and difficulties regarding discipline or the law were common recent stressors among the alcohol abuse victims, and interpersonal conflicts and somatic illness among those with depressive disorders. Compared with the depressive victims, an unstable earlier family history was more common among the alcohol abusers. The accumulation of stressors and weakened parental support during the previous year were also more frequently found in the alcohol abuse victims. CONCLUSIONS: The results indicate that specific psychosocial stressors may be critical for suicidal adolescents with different diagnoses. In the evaluation of suicidal adolescent substance abusers, particularly recent interpersonal separations and family support need to be carefully weighed. Disruptions in the adolescent's interpersonal relationships, excess accumulation of stress, and lacking support from the family may be warning signs of suicide potential and indications for additional social support, for more intensive treatment, or for a change in the treatment setting.

Adolescent↗

PubMed1994

Differences in recent life events between alcoholic and depressive nonalcoholic suicides.

The purpose of this study was to investigate the main differences in recent life events preceding suicide between alcoholic and depressive nonalcoholic suicide victims, how much these differences were sex- and age-dependent, and how social support varied between these groups. Using the psychological autopsy method, retrospective best-estimate diagnoses by DSM-III-R criteria were assigned to a randomized 16.4% sample (n = 229) of suicide victims drawn from a 1-year total nationwide suicide population (n = 1,397) in Finland. Life events during the last 3 months (32 items) and social support (6 items) of 75 suicide victims with alcohol abuse/dependence diagnoses were compared with those of 69 nonalcoholic depressive victims. Among male suicides, the alcoholics had experienced more separations and family discord, financial trouble, and unemployment, whereas the depressives had experienced more somatic illness. Among females, adverse interpersonal events had been common in both alcoholic and depressive victims. Among the alcoholics, unlike the depressives, the number of adverse interpersonal life events had not diminished with increasing age. Living alone had been twice as common among the alcoholic suicides and, in these cases, recent separation, unemployment, and financial trouble were remarkably common, suggesting a concurrent stressor effect. Our results confirm and extend the earlier findings of excess interpersonal stressors among alcoholic suicides compared with depressive suicides. The findings suggest that multiple adverse life events and living alone need to be taken into account in clinical practice when assessing psychosocial stress and suicidal danger in alcoholism.

Adolescent↗

PubMed1994

Fear of acquired immunodeficiency syndrome and fear of other illness in suicide.

Suicide victims with fear of acquired immunodeficiency syndrome (AIDS) or other somatic illness were compared for psychosocial and health-related characteristics, triggers and content of fear. Fear of AIDS cases (n = 28), 2% of the 1-year Finnish suicide population (n = 1397), were younger and fewer had serious somatic disease (32% vs 64%) compared with cases of fear of other somatic illness. Both groups had more depression, especially major depression (54% and 61% vs 26%), more psychotic disorders (50% and 32% vs 24%) and health care contacts during their final week (61% and 64% vs 36%) than other suicides. Suicidal fear of AIDS calls for evaluation of sexual and other risk behaviour, but fear of AIDS was largely generated by the extensive media coverage. Fear of other somatic illness was more diverse in origin and related to illness experiences. Suicidal fear of illness calls for recognition of depression and differentiation of the origin and content of fear.

Adult↗

PubMed1994

Antisocial behaviour in adolescent suicide.

Antisocial behaviour among adolescent suicide victims (44 males, 9 females) was investigated in a nationwide psychological autopsy study of suicides in Finland. The data were collected through interviews of the victims' relatives and attending health care personnel, and from official records. Antisocial behaviour was reported among 43% of the victims. Separation from parents, parental alcohol abuse and parental violence were common among male victims with antisocial behaviour. Their psychosocial adjustment was poor, and they had experienced severe stressors. Depressive disorders were common among all suicides, but male victims with antisocial behaviour had more often alcohol abuse and comorbid mental disorders compared with victims without antisocial behaviour. The results indicate a strong relatedness between adolescent suicide and antisocial behaviour. Recognition and treatment of manifest mental symptoms and evaluation of suicide risk among adolescents with antisocial behaviour and substance abuse is emphasized. Antisocial symptoms with relatively short duration and not severe enough to meet the criteria for actual antisocial disorders also need to be taken into account.

Adolescent↗

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

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↗

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

Female psychoactive substance-dependent suicide victims differ from male--results from a nationwide psychological autopsy study.

Suicides involving alcohol or other substance dependence have been studied in male-dominated populations. We studied male and female suicide victims with DSM-III-R psychoactive substance dependence (PSD) separately in a nationwide psychological autopsy study in Finland. The subjects were substance-dependent males from a systematic random sample and all substance-dependent female suicide victims from the total population of suicides committed over a 1-year period in Finland. Comparisons by sex and age were made, and two logistic models were created predicting sex. Females were more likely to have abused or been dependent on prescribed medication. Female victims aged 40 years or less had a relatively high frequency of borderline personality disorder (BPD), frequent previous suicide attempts, and suicidal communication, whereas older females were more like older males. The onset of a comorbid axis I disorder preceded substance dependence more often among females. Male and female substance-dependent suicide victims differ in a number of characteristics, including previous suicidality, age-related variation in personality disorders, and type of substance used. Findings from studies of predominantly male substance-dependent suicide victims cannot necessarily be generalized to females.

Adult↗

PubMedDate not supplied

Alcohol-related problems among adolescent suicides in Finland.

We studied 106 adolescent suicides out of a total nationwide population of 1397 suicides. Forty-four (42%) of these 13-22-year-old victims were classified as having suffered either a DSM-III-R alcohol use disorder or diagnostically subthreshold alcohol misuse according to retrospective evaluation using the Michigan Alcoholism Screening Test (MAST). These victims were found to differ from the other adolescent suicides in several characteristics: they were more likely to have comorbid categorical DSM-III-R disorders, antisocial behaviour, disturbed family backgrounds, precipitating life-events as stressors and severe psychosocial impairment. In addition, they also had a greater tendency to be alcohol-intoxicated at the time of the suicidal act, which tended to occur during weekends, suggesting that drinking in itself, and its weekly pattern, each contributed to the completion of their suicides.

Adolescent↗