Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide.
Elevated fibrinogen is independently associated with the risk of ischemic myocardial injury following elective PCI with clopidogrel pre-treatment regardless of platelet reactivity as measured by the VerifyNow assay.
Evidence implicates a role of advanced glycation end products (AGEs) in the development of atherosclerosis. The present study examined the relationship between plasma levels of AGEs and the clinical and angiographic characteristics of patients with symptomatic peripheral arterial disease (PAD). A total of 40 consecutive patients with symptomatic lower extremity PAD undergoing invasive evaluation were enrolled. Clinical history, angiographic data, and plasma levels of total AGE (tAGE), N?-carboxymethyllysine (CML), and high-sensitivity C-reactive protein were obtained. In multivariate analyses, there were independent relationships noted between tAGE levels and the presence of critical limb ischemia (CLI) (r 2?=?0.195, p?=?0.003), Rutherford stage (r 2?=?0.351, p?0.001), and the average below the knee (BTK) score (r 2?=?0.119, p?=?0.006). Presence of CLI (r 2?=?0.154, p?=?0.012) and the Rutherford stage (r 2?=?0.194, p?=?0.003) were associated with CML levels. We demonstrate a relationship between tAGE and the symptom profile of patients with PAD and an association between tAGE and infrapopliteal angiographic disease severity. Both tAGE and CML levels were related to the presence of CLI. These data suggest that AGE levels may reflect the severity of PAD and may be of importance in CLI.
Background: Inventory-based methods of detecting individuals at risk of psychosis (e.g., the prodromal questionnaire [PQ]) have been investigated in a series of studies, but the preponderance of studies has relied on clinically referred samples. The present study sought to (1) determine how the PQ compares to the structured interview for psychosis risk syndromes (SIPS) in a nonclinical sample and (2) determine whether adding nonpsychosis questionnaires to the PQ improves detection of individuals at clinical high risk (CHR) for psychosis. Methods: In a nonclinical sample of undergraduates, a series of questionnaires were administered to 2836 participants, and then a subsample was administered the SIPS based on high and low endorsement of positive symptoms on the PQ, using cutoffs from previous clinical studies (51 PQlow and 70 PQhigh). First, an LCA was conducted using the PQ and 19 other clinical and risk factor-based measures (all of which have been associated with psychosis). Second, we examined whether LCA classes were associated with increased the odds of being classified as CHR for psychosis compared to the PQ alone. Third, we combined variables that appeared to best differentiate between LCA classes to determine whether prediction could be improved by adding these variables to the PQ. Results: LCA analyses suggested that a 2-class model best fit the data, with Class 2 elevated on variables frequently associated with psychosis. Being in Class 2 was associated with a 14.5 increased odds of being at CHR for psychosis compared with a 5.6 odds using the PQ cut-off alone. Adding variables to the PQ substantially improved the positive predictive values (PPVs) and specificities of identifying those at CHR for psychosis without any changes in sensitivities or negative predictive values. Specifically, the PQ cutoff alone was associated with an 18.57% PPV, while PPVs ranged from 25 to 28.89% when adding 3 permutations of additional variables. True positives remained similar among the groups; however, adding additional variables substantially reduced the false-positive rates on the SIPS. Conclusion:Findings from the present study suggest that screeners that include nonpsychosis clinical measures (e.g., depression) have the potential to substantially improve detection of who is at CHR for psychosis, which could have major implications for future prevention and intervention studies. SA50. ORGANIC PSYCHOSIS: USING ELECTRONIC PATIENT RECORDS TO INVESTIGATE DEMOGRAPHICS, ETIOLOGY, AND OUTCOMEThomas Misselbrook*, Rashmi Patel, Tim Nicholson, Alexis Cullen, and Tom Pollak King's College London Background: Psychotic disorders due to an identified medical illness are classified using the term "organic," and have been considered separately from "nonorganic" psychotic disorders. Despite having different treatment options and health-care pathways, and with growing criticism of the organic/nonorganic dichotomy in psychotic disorders, very little is known about organic psychoses in terms of prevalence, the relative frequency of cau...
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