Short‐term course of depression following attempted suicide: a preliminary report

Abstract

The course of depression over 1 week in patients admitted to hospital following an attempted suicide was examined utilizing a clinical interview, the Zung Self-Rating Depression Scale, the Levine-Pilowsky Depression (LPD) Questionnaire and the Hamilton Rating Scale for Depression. On all measures the group had depression of moderate to marked severity at the time of attempted suicide. In males there was a statistically and clinically significant reduction in severity of depression over 1 week. This trend was also observed in the younger patients. There was no significant change in the frequency of the LPD category endogenous depression, but examination of changes in DSM-III diagnostic frequencies revealed a significant reduction in major affective disorder over 1 week. Symptom changes were also examined. Factors that may have contributed to the observed changes in depression are discussed. Therapeutic implications and further research directions are outlined.

Self‐determination theory, motivational interviewing, and the treatment of clients with acute suicidal ideation

“…The potential for an SDT-or MIbased approach to increase depressed clients' engagement in treatment that may reduce suicide-related behavior or depression is an important line of research to pursue. We call for such research because individuals who are depressed and attempt suicide may experience a sudden improvement in their depressive symptoms (Bronisch, 1992;Davis, 1990;Jallade, Sarfati, & HardyBayle, 2005;Van Praag & Plutchik, 1985;Walker, Joiner, & Rudd, 2001). Such improvement, which may be dramatic and temporary (Watzlawick, Weakland, & Fisch, 1974), may create a window of opportunity that is particularly well suited to interventions that target clients' motivation and energy.…”

The Course of Post‐Crisis Suicidal Symptoms: How and for Whom Is Suicide “Cathartic”?

“… We investigated suicide “catharsis” as evidenced by decreased suicidality following a suicide attempt. Past research has examined this issue with mixed results (Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985). In the present study, we examined Modified Scale for Suicide Ideation (MSSI) scores for 198 suicidal men during suicidal crisis, prior to entry into a treatment study, and again at 1‐month and 12‐month follow‐ups.…”

“…This notion of catharsis has been espoused by several researchers (Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985) who investigated changes in symptoms following a suicide attempt. These researchers and others have used the terms catharsis and cathartic effect to describe the significant decrease in symptoms following a suicidal crisis (see Bronisch, 1992; Davis, 1990; Newson‐Smith, 1979; van Praag & Plutchik, 1985). All agree that the concept of suicide catharsis warrants further empirical study.…”

“…In addition to the mixed findings on the cathartic effects of aggression, three empirical studies have investigated the surprising possibility that suicide attempts are associated with symptom diminution (i.e., may be cathartic; Bronisch, 1992; Davis, 1990; van Praag & Plutchik, 1985). Van Praag and Plutchik (1985) speculated that a suicide attempt might specifically serve to alleviate negative feelings that the patient experienced prior to the attempt.…”

¿Están los grandes repetidores adictos a los comportamientos suicidas?

“…Beck (1996) suggested that previous SB sensitizes suicidal thoughts and behaviors, such that they become more autonomous and easily precipitated. Self-aggression ameliorates the physical and emotional tension that precedes SB, depressive and anxiety symptoms, and painful emotions (i.e., hopelessness, emptiness) (Davis, 1990;Jallade, Sarfati, and Hardy-Bayle, 2005;Sarfati, Bouchaud, and Hardy-Bayle, 2003;van Praag and Plutchik, 1985;Walker et al, 2001). In a pilot fMRI study with eight female subjects, mental pain triggering SB was associated with decreased prefrontal activity, whereas "planning and acting out suicidal impulses in response to mental pain" was related to increased activity in the frontal cortex, suggesting that SB reduces mental pain (Reisch et al, 2010).…”