Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide: a controlled trial

Article Abstract:

Recent studies indicate that patients who have attempted suicide tend to have deficits in problem-solving abilities such as the ability to deal with stressors. In order to evaluate a cognitively-based problem-solving treatment program, 20 female and male patients aged 16 to 65 years who had recently attempted suicide were randomly assigned to either a problem-solving treatment group (12 patients) or a 'treatment-as-usual' control group (eight patients). The problem-solving treatment consisted of five sessions in which patients were taught to identify problems, arrange them for problem solving, generate solutions and goals, and work out strategies for achieving those goals. Assessments of all patients included the Beck Depression Inventory (BDI), the Beck Suicidal Ideation scale (which measures thoughts, plans and attitudes related to future suicide attempts), a hopelessness scale, and a questionnaire in which the patient generates a personal problem list rated in order of importance and difficulty. Results demonstrated that the problem-solving treatment led to significantly better results in terms of ability to solve personal problems, and significantly improved ratings on the BDI, the Beck Suicidal Ideation scale and the hopelessness scale. At a one-week assessment, only the hopelessness scale demonstrated significant differences between groups, while other significant differences were first detected after one month had elapsed. Although results of a one-year follow-up assessment seem to suggest that a brief problem-solving treatment can reduce stress in suicidal patients, evaluations of larger groups of patients are required. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Suicide prevention, Study and teaching, Problem solving

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Suicide among immigrant psychiatric patients in Canada

Article Abstract:

Lower social class among immigrants has been associated with a greater risk for mental illness, and mental illness has been linked with suicide. Therefore, there may be a relationship between lower social class among immigrants and suicide; the results of previous studies support this relationship. In the present study, designed to further investigate suicide among immigrant psychiatric patients, 94 Canadian-born psychiatric patients who committed suicide were compared with 23 immigrants to Canada who committed suicide. Most immigrants came to Canada as young adults to seek a better life and had been in the country for an average of 17 years before committing suicide. Among the immigrants, 73.9 percent underwent major life stresses prior to suicide compared with 35.1 percent of the Canadian sample. Unemployment levels were high in both groups, but immigrants were better educated than the Canadian group. About half the immigrants were living alone at the time they killed themselves compared with 33.7 percent of nonimmigrants. Families of immigrants had an incidence of mental illness of 13.6 percent compared with an incidence of 41.8 percent for the Canadian families. Prior psychiatric hospitalizations had occurred in 39 percent of immigrants and in 56 percent of nonimmigrants. In general, the profile of the mentally ill immigrant at risk for suicide differed from the profile of the nonimmigrant. It is suggested that social and cultural factors influence the onset, presentation, and process of mental illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Canada, Immigrants

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