Evidence has shown that during times of crises, suicide rates can decrease but tend to increase as the crisis alleviates. The consequences of the global COVID-19 pandemic, whether direct or indirect, will be far reaching. In this chapter the impact of the pandemic on the risk and protective factors of suicide, grouped according to the socio-ecological model at individual, relationship, community, and society levels, is described. To prevent unnecessary suicides, the effects of Covid-19 pandemic, on health care and public health suicide prevention strategies, and recommendations for implementation are presented.
The aim of this open label trial was to evaluate mirtazapine tolerability and effectiveness in controlling symptomatology of patients with panic disorder. Forty-five patients with panic disorder, with or without agoraphobia, 11 of them with a comorbid diagnosis of major depression, were included. Patients were assessed with a structured psychiatric interview and their symptomatology evaluated with specific psychometric scales. Three study participants dropped out due to adverse events. Mirtazapine was administered at an established dose of 30 mg daily for 3 months. Patients were assessed at weeks 2 and 4, and then at monthly intervals. All psychometric measures showed statistically significant reductions in total scores at the rated time points, with a pronounced decline in number and intensity of panic attacks and anticipatory anxiety throughout the study. Mirtazapine was well tolerated as signified by the low discontinuation rate (6.3%), and all patients showed a significant symptomatic improvement. The improvement did not appear to be linked to the concurrent presence of a depressive illness.
Multiple risk factors have been involved in the risk for suicide
and multiple trajectories have been hypothesized leading to suicidal behaviour.
Consistent evidence suggests the involvement of heritable factors, as well as a
critical role of life stress and early adversity. In the present article we will
review the evidence for the involvement of genetic, environmental as well as
personality traits in the risk for suicide, together with recent evidence
supporting an interaction between these different factors.
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