Suicide prevention by suicide detection.
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Biomedical subjects
Publications and source records attributed to W W Zung.
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The authors tested the hypothesis that people addicted to opiates manifest more psychopathology in areas that have been identified as predictors for high risk of suicidal behavior than do normal control subjects. They gave 278 patients in a methadone maintenance program and 207 normal control subjects the index of Potential Suicide (IPS), a scale designed to assess suicidal risk. Using discriminate function analysis, the authors found that 87% of 100 of the methadone patients and 98% of 100 of the normal control subjects were correctly identified on the basis of the IPS data.
We have previously reported 10 patient histories involving various intractable pain syndromes where the administration of Haloperidol either eliminated the need for narcotic analgesics or resulted in a significant reduction in narcotic dosage. We are presently undertaking a controlled double-blind evaluation of Haloperidol as an adjunctive treatment for intractable cancer pain. Based upon the reported clinical observations, these findings are discussed from the following aspects: 1. The isomeric similarity of Haloperidol to Meperidine. 2. Dose response between Haloperidol and analgesic effect. 3. The clinical literature regarding the use of Haloperidol for the effective withdrawal or maintenance of narcotic addicts. 4. The analgesic property as it relates to the opiate receptor.
Struve has suggested that paroxysmal EEG abnormality is considerably more frequent in suicidal psychiatric inpatients than in nonsuicidal psychiatric inpatients. In order to see if these observations were confirmed in other populations, the Zung Index of Potential Suicide and scalp EEG were administered to 216 consecutively admitted VA psychiatric inpatients. The results indicated only slightly greater EEG abnormality in suicidal patients (14.9%), than in nonsuicidal patients (6.6%) statistical analysis failed to support either a general association between overall EEG abnormality and suicidal behavior, or the specific association between paroxysmal EEG abnormality and suicidal behavior, reported by Struve. Some of the data suggested that further EEG observations might be worthwhile on patients in the Threatener subcategory of suicidal behavior.
This study substantiates previous reports that low platelet MAO activity is associated with alcoholism. The results also indicate that low platelet MAO activity in alcoholic probands is associated with a higher prevalence of psychiatric hospitalization in first-degree family members as well as alcoholism and suicide attempts among alcoholics. Psychiatrically ill family members of the alcoholic probands with low platelet MAO activity also demonstrate low enzyme activity whereas the well family members have normal enzyme activity.
Previous reports suggest that tricyclic antidepressants inhibit platelet monoamine oxidase (MAO) activity in vitro and in vivo. This study was undertaken to examine the relationship between tricyclic-mediated inhibition of platelet MAO and resolution of clinical signs and symptoms which are commonly associated with the depressive syndrome. The results indicate that the sedative-hypnotic effects of the tricyclics closely correlate with the magnitude of platelet MAO inhibition. It appears that these effects may be mediated through alterations in the metabolism of serotonin and/or the phenylethylamines.
A survey of symptomatology of depressed patients and normal subjects in India was conducted, using a previously developed operational definition for depressive disorders that had been converted into a Self-Rating Depression Scale (SDS). Results obtained from 430 depressed and 97 normal subjects showed that depressed patients scored significantly higher on 18 of the 20 individual items of the SDS, as well as the SDS index, than did normal subjects (P= less than .01). Correlation between the physician's global rating of the patient's depression and patient's own self-rating was 0.74 (P= less than .01). A comparison of these results in India with those previously obtained in the United States, Japan, Czechoslovakia, England, Germany, and the Netherlands showed that depressed patients scored similarly in all the countries studied.
While suicide prevention services are continually expanding, efforts to measure their efficacy are seldom found in the literature. This study examines the effect of suicide prevention centers in North Carolina on the suicide rate in 1970. The data are examined in a ecological context, i.e., pertinent demographic variables are included in the analysis of the suicide rate in North Carolina counties with an emphasis on structural and contextual effects. A review of the literature on suicide prevention center efficacy, a description of those counties in North Carolina that support such centers, and a rigorous testing of their effect on the countywide suicide rate are undertaken in the present analysis. All of the analyses of the data indicate that the centers have minimal effect on the suicide rate.
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