Gaia Meneghel

Blindness, Fear of Sight Loss, and Suicide

Numerous studies have examined the emotional impact exerted by sight loss. Research has tended to focus on clinical-diagnostic rather than therapeutic-preventive aspects. Blindness and sight restoration have been reported to induce both temporary and longer term psychopathology, usually followed by psychosocial readjustment. However, in some cases, readjustment may not occur and suicide may result. Together with an extensive review of available literature, the authors present cases taken from their psychological autopsy study database. When compared with a hearing-impaired control group, impaired sight alone can acutely affect otherwise psychologically healthy individuals. Ophthalmologists need to be aware of this problem and to develop closer collaboration with mental health professionals. Serious consideration of this problem and definition of clear guidelines may prevent suicidal behaviour.

Death ideation and its correlates: survey of an over-65-year-old population

The presence of dissatisfaction with life or thoughts of death or suicide has been variously surveyed in adolescent samples and in the general population, but there is a paucity of research on the elderly. The aim of this study was to assess, in an elderly community-dwelling population: a) the prevalence of death and/or suicidal feelings and thoughts and any attempted suicides; and b) factors associated with these experiences. A total of 611 over-65-year-old subjects were interviewed at home. Seventeen percent of the total (F:M = almost 2:1) responded affirmatively to at least one of the questions on suicidality. Elderly people reporting suicidal feelings presented markedly higher levels of physical and psychological distress, such as depression, anxiety, and hostility. Results indirectly confirm that depressive symptomatology is not adequately treated. Greater attention is warranted in psychological evaluation of the elderly to take into account those risk factors that, if identified and managed, could reduce the frequency of suicidal thoughts and, probably, associated actions.

Pharmacological and Psychotherapeutic Treatment of Personality Disorders in the Elderly

Although estimates as to the incidence of personality disorder in the elderly remain controversial, it is well known that such a disorder is prevalently ego-syntonic and capable of interfering with the onset and treatment of other somatic and psychic pathologies, especially in later life, when individuals tend tobe particularly vulnerable. Misdiagnosis or failure to treat these disorders may greatly diminish the quality of life of older adults and their families. The aim of this work is to define the chief psychopharmacological and psychotherapeutic guidelines for treating personality disorders in the elderly. Pharmacologically, patients require treatment with molecules designed to rebalance neurotransmitter system alterations, which underlie the symptomatological picture. As regards psychotherapeutic treatment, although there are only a few validation studies, we believe that dialectical behavior therapy and interpersonal psychotherapy may constitute valid therapeutic approaches that meet both the needs and the individual characteristics of patients affected by personality disorder and those of elderly patients.

Hostility as a Feature of Elderly Suicidal Ideators

Literature suggests that suicidal feelings are relatively rare in mentally healthy older adults. This research investigated the presence of death or suicidal ideation in a group of home-dwelling elderly people (N = 611, M age = 75.7 yr., SD = 7.2), taking into account their psychopathological profiles assessed by means of the Brief Symptom Inventory. Suicidality was investigated by the Italian translation of the 1974 questions from Paykel, Myers, Lindenthal, and Tanner. Elderly with death or suicidal ideation manifested depressive and anxious symptoms on the Brief Symptom Inventory. This psychopathological profile, which has been reported for these subjects in various contributions to the literature, was also characterized by the presence of hostility. The correlation with higher scores on the hostility scale is difficult to interpret, although these feelings are often accompanied by failure to control impulses, which is an essential characteristic in suicidal behaviour.

Applicability of Neural Networks to Suicidological Research: A Pilot Study

Suicide is a leading cause of death internationally. Prediction of the phenomenon has proved to be extremely difficult and results in this area have been modest. The objective of this pilot study was to assess the applicability of the Neural Network statistical procedure to suicidal data. The predictive ability of three statistical techniques (Logistic Regression, Discriminatory Analysis and Neural Networks) were compared in the ability to distinguish between suicides and attempts on the basis of a variety of variables. Although the Neural Network model expresses its full potential with large numbers, it has proved to be effective even in our limited sample. This suggests that neural networks may exhibit superior predictive capacity when the data set is enlarged. This technique may prove to be a useful additional tool in the field of suicide prediction and prevention.

Dysphoria and Mood Disorders in Menopause

According to an International Health Foundation report, the psychic disorders which may be manifested in the climacteric, are present in 30–40% of cases [1]. The menopause may, on the other hand, exhibit itself as a totally natural event, unmarked by psychological trauma and unaccompanied by any specific symptom. In this respect, it has recently been observed that the women in the Mayan American Indian population of the Yucatan have an asymptomatic menopause, although the endocrinological and metabolic processes are exactly the same as in European women [2].