Comorbidity of Axis I and Axis II Disorders in Patients Who Attempted Suicide

Hawton, Keith; Houston, Kelly; Haw, Camilla; Townsend, Ellen; Harriss, Linton

doi:10.1176/appi.ajp.160.8.1494

Cited by 171 publications

(126 citation statements)

References 31 publications

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“…There is a strong association of PD comorbidity with earlier age of onset (Brieger et al 2002, Ozkan & Altindag 2005; greater clinical severity (Ozkan & Altindag 2005); poorer treatment outcome (Farabaugh et al 2005, Ogrodniczuk et al 2001; longer time to remission (Grilo et al 2005, Massion et al 2002; lower long-term social, cognitive, and occupational functioning (Bank & Silk 2001, Denys et al 2004, Smith & Benjamin 2002, Tyrer et al 2003; greater medical utilization (Smith & Benjamin 2002); suicide attempts and completion (Garno et al 2005, Hawton et al 2003; and greater risk of psychopathology in offspring (Abela et al 2005). However, worse outcome-including increased time to remission-is not inevitable (Grilo et al 2000), varies by PD (Grilo et al 2005), and to some extent may reflect methodological flaws rather than true effects (Mulder 2002).…”

Section: Complications Of Comorbiditymentioning

confidence: 99%

Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization

Clark

2007

Annu. Rev. Psychol.

701

718

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This chapter reviews recent (2000)(2001)(2002)(2003)(2004)(2005) personality disorder (PD) research, focusing on three major domains: assessment, comorbidity, and stability. (a) Substantial evidence has accrued favoring dimensional over categorical conceptualization of PD, and the five-factor model of personality is prominent as an integrating framework. Future directions include assessing dysfunction separately from traits and learning to utilize collateral information. (b) To address the pervasiveness and extent of comorbidity, researchers have begun to move beyond studying overlapping pairs or small sets of disorders and are developing broader, more integrated common-factor models that cross the Axis I-Axis II boundary. (c) Studies of PD stability have converged on the finding that PD features include both more acute, dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable-similar to normal-range personality traits-with increasing stability until after 50 years of age. A new model for assessing PDand perhaps all psychopathology-emerges from integrating these interrelated reconceptualizations.

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Section: Complications Of Comorbiditymentioning

confidence: 99%

Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization

Clark

2007

Annu. Rev. Psychol.

701

718

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“…Many service members who have been previously deployed experience other mental health conditions or cognitive impairments, such as TBI and related psychiatric comorbidities (Carlson et al, 2010). Additionally, other factors that may also be associated with deployment-such as high propensities of risktaking, impulsivity, and anger (MacManus et al, 2015)-can be indicators of other mental health problems and adverse health-related behaviors, such as suicide ideation and attempts (Hawton et al, 2003;Novaco et al, 2012). Serious mental illnesses often trigger long-term negative health and social outcomes, such as marital instability and even homelessness, and understanding the long-term effects of deployment and combat exposure on mental health is vital to reducing such negative outcomes.…”

Section: Deployment and Mental Healthmentioning

confidence: 99%

2015 Department of Defense Health Related Behaviors Survey (HRBS)

Meadows¹,

Engel²,

Collins³

et al. 2018

156

165

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Library of Congress Cataloging-in-Publication Data For more information on this publication, visit www.rand.org/t/RR1695Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2018 RAND CorporationR® is a registered trademark. Cover photo credits from top to bottom:Photo by Cpl PrefaceThe Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense's flagship survey for understanding the health, health-related behaviors, and well-being of service members. Originally implemented to assess substance use (i.e., illicit drugs, alcohol, and tobacco), the survey now includes content areas-such as mental and physical health, sexual behavior, and postdeployment problems-that may affect force readiness or the ability to meet the demands of military life. The HRBS is intended to supplement administrative data already collected by the armed forces. In 2014, the Defense Health Agency asked the RAND Corporation to review previous iterations of the HRBS, update survey content, administer a revised version of the survey, and analyze data from the resulting 2015 HRBS of active-duty personnel. The 2015 HRBS included U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard personnel, and this report details the survey methodology and results. No expertise in health, health-related behaviors, or health care is required to read this report. However, it may be of most use to individuals who provide direct care related to the health and health-related behaviors of active-duty service members or who are responsible for making related policy decisions. Additional information can be found in a series of online appendixes.This research was sponsored by the Defense Health Agency and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelli...

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“…More specifically, pain-related physical conditions like migraine and back pain have been associated with an increased risk of suicidal behaviours (Ilgen et al, 2013;Smith et al, 2004) The influence of multiple mental illnesses on risk of suicide is of considerable interest from a global public health perspective. Several studies have reported that major depression, anxiety disorder and substance abuse are often found to co-occur with other psychiatric conditions within suicidal populations (Hawton et al, 2003a;Nock et al, 2010;Suominen et al, 1996). Such findings suggest an increased risk among people with specific multimorbid psychiatric diagnoses and highlight the need for more targeted support from mental health services (Andrews and Lewinsohn, 1992;Bronisch and Wittchen, 1994;Mościcki, 2001;Oquendo et al, 2005;Pawlak et al, 1999;Wunderlich et al, 1998).…”

Section: Introductionmentioning

confidence: 99%