From the Serotonin Model of Suicide to a Mental Pain Model of Suicide

Leon, José de; Baca‐García, Enrique; Blasco-Fontecilla, Hilario

doi:10.1159/000438510

Cited by 38 publications

(31 citation statements)

References 68 publications

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“…An issue that is not sufficiently appreciated is the experience of mental pain many patients have [48,49,50,51]. Patients sometimes mention this experience spontaneously, but in other cases only upon specific questions (which, however, are seldom asked).…”

Section: Emerging Perspectivesmentioning

confidence: 99%

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Well-Being Therapy: Current Indications and Emerging Perspectives

Fava

2016

Psychother Psychosom

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Section: Emerging Perspectivesmentioning

confidence: 99%

“…Grief provides an example of the sense of emptiness, loss of meaning and suffering that mental pain entails. Mental pain may or may not be associated with anxiety and/or depression [48,49,50,51]. It is conceivable and yet to be tested that WBT may counteract the manifestations of mental pain [16].…”

Section: Emerging Perspectivesmentioning

confidence: 99%

Well-Being Therapy: Current Indications and Emerging Perspectives

Fava

2016

Psychother Psychosom

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“…The complexity of this behavior is illustrated by the difficulties in predicting suicides and suicide attempts with sufficient certainty - despite a host of risk factors that have been published [12,13,14,15]. For an overview of methodological difficulties in suicide research, see the study by de Leon et al [16]. …”

Section: Introductionmentioning

confidence: 99%

Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder

Braun¹,

Bschor

Franklin

et al. 2016

Psychother Psychosom

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Background: It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during long-term use. Methods: We carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). Sources were obtained from 5 review articles and by searches of MEDLINE, PubMed Central and a hand search of bibliographies. We meta-analyzed placebo-controlled antidepressant RCTs of at least 3 months' duration and calculated suicide and suicide attempt incidence rates, incidence rate ratios and Peto odds ratios (ORs). Results: Out of 807 studies screened 29 were included, covering 6,934 patients (5,529 patient-years). In total, 1.45 suicides and 2.76 suicide attempts per 1,000 patient-years were reported. Seven out of 8 suicides and 13 out of 14 suicide attempts occurred in antidepressant arms, resulting in incidence rate ratios of 5.03 (0.78-114.1; p = 0.102) for suicides and of 9.02 (1.58-193.6; p = 0.007) for suicide attempts. Peto ORs were 2.6 (0.6-11.2; nonsignificant) and 3.4 (1.1-11.0; p = 0.04), respectively. Dropouts due to unknown reasons were similar in the antidepressant and placebo arms (9.6 vs. 9.9%). The majority of suicides and suicide attempts originated from 1 study, accounting for a fifth of all patient-years in this meta-analysis. Leaving out this study resulted in a nonsignificant incidence rate ratio for suicide attempts of 3.83 (0.53-91.01). Conclusions: Therapists should be aware of the lack of proof from RCTs that antidepressants prevent suicides and suicide attempts. We cannot conclude with certainty whether antidepressants increase the risk for suicide or suicide attempts. Researchers must report all suicides and suicide attempts in RCTs.

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“…Further, high sensitivity is required for detecting residual symptomatology, which was found to characterize the majority of patients who were judged to be remitted according to DSM criteria and no longer in need of active treatment [39]. Excessive reliance on symptoms that are part of diagnostic criteria of mental disorders (e.g., major depressive disorder, generalized anxiety disorder) has impoverished clinical assessment in psychopharmacology and does not reflect the broad spectrum of variables that affect clinical presentations: subclinical distress [39], such as demoralization and irritable mood [40], psychological well-being and euthymia [41,42,43], mental pain [44,45,46,47], social adjustment [48], and neuroticism [49,50]. …”

Section: Areas Of Applicationmentioning

confidence: 99%

Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks

Fava

Tomba

Bech

2017

Psychother Psychosom

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The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology is outlined, with discussion of its most representative expressions and reference to current challenges of clinical research, with particular reference to clinimetrics. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug treatment and psychological variables. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with (a) wanted and expected treatment effects, (b) treatment-induced unwanted side effects, and (c) the patient's own personal experience of a change in terms of well-being and/or quality of life. Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Research in this area deserves high priority.

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From the Serotonin Model of Suicide to a Mental Pain Model of Suicide

Cited by 38 publications

References 68 publications

Well-Being Therapy: Current Indications and Emerging Perspectives

Well-Being Therapy: Current Indications and Emerging Perspectives

Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder

Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks

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