ABSTRACT
The author suggests that a new paradigm may be needed which holds that some suicides may be inevitable. The goal of this paradigm would be to diminish the sense of failure and inadequacy felt by many psychiatrists who experience the suicide of a patient and to increase understanding of the unique biopsychosocial profile of those whose suicides appear to be inevitable. The author stresses that this proposed paradigm should not be misconstrued as therapeutic nihilism but rather should serve to stimulate efforts to treat this patient population more effectively. Risk factors that place individuals at high risk for suicide are reviewed, including presence of a mental illness, genetic predisposition, and factors such as a history of abuse, divorce, unemployment, male gender, recent discharge from a psychiatric hospital, prior suicide attempts, alcohol or other substance abuse, a history of panic attacks, and persistent suicidal thoughts, especially if coupled with a plan. The author notes that, in those suicides that appear to have been inevitable, risk factors are not only numerous but at the extreme end of profound pathology. The example of Ernest Hemingway is used to illustrate how such a combination of risk factors may have contributed to his eventual suicide. Psychiatrists, like other doctors, may have to acknowledge that some psychiatric disorders are associated with a high mortality rate as a natural outcome. This could lead to heightened vigilance, a more realistic view of what can and cannot be achieved with therapy, and efforts to improve the quality of life of patients at high risk for suicide with the goal of reducing this risk and prolonging their lives. (Journal of Psychiatric Practice 2012;18:221-224).
Subject(s)
Professional-Patient Relations/ethics , Psychotherapy/ethics , Suicide/psychology , Famous Persons , Female , Genetic Predisposition to Disease , History, 20th Century , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/genetics , Models, Psychological , Risk Factors , Suicide/history , United States , Suicide PreventionSubject(s)
Humans , Child Psychiatry , Learning Disabilities , Tic Disorders , Geriatric Psychiatry , Forensic PsychiatryABSTRACT
El segundo volumen de la sexta edición del presente Tratado de Psiquiatría se dedica a recorrer los siguientes temas: adicciones, esquizofrenia, psicosis, trastornos del estado de ánimo, ataques de pánico, trastornos del sueño y de la alimentación y sexualidad humana normal y trastornos de la identidad sexual
ABSTRACT
Este primer volumen de la sexta edición del presente Tratado de Psiquiatría está destinado a presentar las ciencias que tratan con la enfermedad mental psiquiatría, neurociencias, neuropsiquiatría, neurología, psicología y hasta un trabajo dedicado al psicoanálisis
ABSTRACT
Este primer volumen de la sexta edición del presente Tratado de Psiquiatría está destinado a presentar las ciencias que tratan con la enfermedad mental psiquiatría, neurociencias, neuropsiquiatría, neurología, psicología y hasta un trabajo dedicado al psicoanálisis
ABSTRACT
El segundo volumen de la sexta edición del presente Tratado de Psiquiatría se dedica a recorrer los siguientes temas: adicciones, esquizofrenia, psicosis, trastornos del estado de ánimo, ataques de pánico, trastornos del sueño y de la alimentación y sexualidad humana normal y trastornos de la identidad sexual
Subject(s)
Humans , Psychiatry/education , Psychiatric Status Rating Scales , Psychotherapy/methods , Psychopharmacology , Child Psychiatry , Substance-Related Disorders , Substance-Related Disorders , Schizophrenia , Suicide , Forensic Psychiatry , Geriatric Psychiatry , Adolescent Psychiatry , Ethics , Anxiety Disorders , Bipolar Disorder , Depression , Sleep Wake Disorders , AIDS Dementia Complex , Neurophysiology , Personality Disorders , Adjustment Disorders , Somatoform Disorders , Dissociative Disorders , Sexual Dysfunctions, Psychological , Sexual Dysfunctions, Psychological , Paraphilic DisordersABSTRACT
Visión general de la psiquiatría de urgencia.Problemas clínicos en la psiquiatría de urgencias