Delay discounting describes the tendency to devalue delayed consequences or future prospects. The degree to which an individual discounts delayed events appears trait-like in that it is stable over time and across functionally similar situations. Steeply discounting delayed rewards is correlated with most substanceuse disorders, the severity of these disorders, rates of relapse to drug use, and a host of other maladaptive decisions affecting human health. Longitudinal data suggest steep delay discounting and high levels of impulsive choice are predictive of subsequent drug taking, which suggests (though does not establish) that reducing delay discounting could have a preventive health-promoting effect. Experimental manipulations that produce momentary or long-lasting reductions in delay discounting or impulsive choice are reviewed, and behavioral mechanisms that may underlie these effects are discussed. Shortcomings of each manipulation technique are discussed and areas for future research are identified. Although much work remains, it is clear that impulsive decision making can be reduced, despite its otherwise trait-like qualities. Such findings invite technique refinement, translational research, and hope.

In spite of a substantial number of suicides in patients with schizophrenia, this area of research has until very recently been the Cinderella of schizophrenia research. Both clinical and research practices have been hampered by a lack of assessment tolls specifically designed to measure suicidality in patients with schizophrenia. This has partly been because of uncertainty about what constitutes reliable risk factors for suicide in schizophrenia. A literature search following evidence-based guidelines was carried out. A number of relevant articles were found, which were then critically reviewed. The majority of rating scales used for patients with schizophrenia were actually based--at least partly--on patients with other diagnoses than schizophrenia (affective conditions, schizoaffective disorder). This procedure could result in misleading conclusions as a result of the heterogeneity of the different mental illnesses. We conclude that, at present, only one rating scale measuring suicidality specifically designed for patients with schizophrenia (the InterSePT-scale) is based on both sound methodology and has clinical relevance. Suicide in patients with schizophrenia remains a pressing problem in the treatment of this high-risk group.

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Since medical assistance in dying (MAiD) became legal in Canada in 2016, there have been concerns about vulnerable people feeling pressured to end their lives. It is important to understand what people in marginalized communities know and feel about MAiD in order to help prevent any pressure to hasten death and to prevent any barriers to accessing assisted death. This qualitative study explored the perceptions and experiences of MAiD and other end-of-life care options with 46 people who were illicit substance users, living in poverty, or who worked with marginalized people in these communities. Six broad themes were identified: the importance of family, friends, and community; the effects of the opioid crisis; barriers to accessing end-of-life care services; support for MAiD; the difference between suicide and MAiD; and what constitutes a good death. Findings from this research may be used to help inform future legislation, professional guidelines, and standards of best practice.