Suicide Attempts With Psychotherapeutic Drugs

Brophy, James J.

doi:10.1001/archpsyc.1967.01730300012003

Cited by 27 publications

(3 citation statements)

References 16 publications

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“…Pharmacotherapy for SITBs became increasingly popular throughout the 1980s, 1990s, and 2000s, with drugs ranging from selective serotonin reuptake inhibitors to antipsychotics to ketamine being tested for potential effects on several SITB outcomes. But early on in the history of pharmacotherapy, some became concerned by emerging evidence that a large proportion of suicide attempts involved overdoses of psychiatric medications (Brophy, 1967). And in the 2000s, controversy arose over mixed evidence that certain antidepressants may cause suicidality (see Friedman & Leon, 2007) and evidence that antidepressant effects on depression may be largely indistinguishable from placebo effects (Kirsch, 2008).…”

Section: Prefrontal Lobotomy (1930s-1950s)mentioning

confidence: 99%

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

Fox

Huang

Guzmán

et al. 2020

Psychological Bulletin

177

151

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Self-injurious thoughts and behaviors (SITBs) are major public health concerns impacting a wide range of individuals and communities. Despite major efforts to develop and refine treatments to reduce SITBs, the efficacy of SITB interventions remains unclear. To provide a comprehensive summary of SITB treatment efficacy, we conducted a meta-analysis of published randomized controlled trials (RCTs) that have attempted to reduce SITBs. A total of 591 published articles from 1,125 unique RCTs with 3,458 effect sizes from the past 50 years were included. The random-effects meta-analysis yielded surprising findings: The overall intervention effects were small across all SITB outcomes; despite a near-exponential increase in the number of RCTs across five decades, intervention efficacy has not improved; all SITB interventions produced similarly small effects, and no intervention appeared significantly and consistently stronger than others; the overall small intervention effects were largely maintained at follow-up assessments; efficacy was similar across age groups, though effects were slightly weaker for child/adolescent populations and few studies focused on older adults; and major sample and study characteristics (e.g., control group type, treatment target, sample size, intervention length) did not consistently moderate treatment efficacy. This meta-analysis suggests that fundamental changes are needed to facilitate progress in SITB intervention efficacy. In particular, powerful interventions target the necessary causes of pathology, but little is known about SITB causes (vs. SITB correlates and risk factors). The field would accordingly benefit from the prioritization of research that aims to identify and target common necessary causes of SITBs.

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Section: Prefrontal Lobotomy (1930s-1950s)mentioning

confidence: 99%

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

Fox

Huang

Guzmán

et al. 2020

Psychological Bulletin

177

151

View full text Add to dashboard Cite

show abstract

“…Also the collection of attitudinal data about completed suicides is difficult because relatives as informants are influenced by the taboo of suicide. Brophy (22) estimated that recorded suicides in the United States each year amount to only about one‐third of the actual number. The reasons for the disparity have to do with: 1) criteria for certifying death as suicide, 2) religious attitudes, and 3) social pressures.…”

Section: Prediction and Preventionmentioning

confidence: 99%

Suicide by Overdoses of Medicines Among the Aged†

Benson

Brodie

1975

J American Geriatrics Society

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The current literature on suicide by medicinal overdose among the elderly population of the United States and Britain is discussed. The older white male is a high risk in this regard. Physical and mental illnesses contribute to the problem of suicide among the aged, and some of the drugs prescribed for treatment (e.g., barbiturates and psychotherapeutic agents) are often accessible to the older person for misuse in suicide. The responsibilities of the prescribing physician and the practices of the dispensing pharmacist are considered in relation to the exposure of the elderly patient to potentially lethal drugs. Prediction of suicidal attitudes in the elderly is complicated by the fact that any attempt at suicide usually is serious and rarely preceded by gestures. Depression, based on social factors, is common among older people. Some of them face problems of declining income and prestige, as well as a loss of physical and mental powers. A change in the attitude of society towards the elderly may help to alleviate the depressive state which so often contributes to the suicidal potential.

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“…In the United States 60% of prescriptions for psychotropic medication were found to come from general practitioners or internists (12), though the pattern for use of such drugs may vary with age (13). The implications for primary prevention were clear (14).…”

mentioning

confidence: 99%

A comparison of self‐injury and self‐poisoning from the Regional Poisoning Treatment Centre, Edinburgh

Robinson

Duffy

1989

Acta Psychiatr Scand

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Injury and poisoning episodes at the Regional Poisoning Treatment Centre, Edinburgh, were compared for the years 1980-1986. Injury was more likely to be associated with youth, male sex and single status. When these demographic differences were controlled for, injury was found to be associated with the following clinical variables: personality disorder, previous psychiatric inpatient status, use of alcohol at the time of parasuicide and alcohol problems, and the social variables-violence against others and received from relatives in the preceding 5 years, criminal record and unemployment. These have been consistently associated with repetition of parasuicide. A history of injury as a putative marker of repetition and the clinical implication of its association with alcohol problems are discussed.

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Suicide Attempts With Psychotherapeutic Drugs

Cited by 27 publications

References 16 publications

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

Suicide by Overdoses of Medicines Among the Aged†

A comparison of self‐injury and self‐poisoning from the Regional Poisoning Treatment Centre, Edinburgh

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