María Dolores Braquehais

Posttraumatic stress disorder, depression, and suicide in veterans

Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions. In military veterans, depression, posttraumatic stress disorder, and suicidal thoughts are common and closely linked.

Bullying, psychiatric pathology and suicidal behavior

Abstract Bullying is a highly prevalent behavior which carries a significant social, medical and financial cost for its victims and perpetrators, with powerful and long-lasting psychological and social impact. Bullying has been defined as a specific form of intentional, repeated aggression, that involves a disparity of power between the victim(s) and perpetrator(s). The aggression can take physical, verbal or gestural forms. The behavior of bullying crosses sociodemographic categories of age, gender, ethnicity, level of academic achievement and professional environment. It has been abundantly observed by teachers and parents in elementary schools, but has also shown its negative presence in corporate boardrooms. The direst outcome of bullying, for both victims and perpetrators, is an increased risk of psychiatric disorders including depression, post-traumatic stress disorder, anxiety disorders, substance abuse and suicidal behavior. Cruelty (and bullying, as one of its manifestations) breaks the basis of morality. Mental health professionals usually treat the victims of those actions unfortunately long after they have been exposed to the harm. The evidence does not support the idea that the majority of cruel actions are intrinsically “pathological”, in the sense of being motivated by “mental disorders”. Therefore, only moral rules and legal actions – but not psychiatric or psychological interventions – may dissuade humans from this form of cruelty.

Hypothalamic-pituitary-adrenal axis dysfunction as a neurobiological correlate of emotion dysregulation in adolescent suicide

BackgroundBiological markers of vulnerability for current or future risk of suicide in adolescents could be important adjuncts to the treatment and prevention of this phenomenon.Data sourcesWe conducted a PubMed search of all English-language articles published between January 1990 and June 2011 using the following search terms: (“hypothalamic-pituitary-adrenal” OR “HPA”) AND (“adolescence” OR “adolescent” OR “teenager”) AND (“depression” OR “major depressive disorder” OR “suicidal behavior” OR “suicidal ideation” OR “suicidal thoughts” OR “deliberate self-harm” OR “suicidal attempt” OR “suicide”).ResultsHPA axis activity can be examined using different methods that do not have the same biological interpretation. An abnormal HPA axis functioning together with an anomalous interaction between HPA mechanisms and other systems such as the serotonergic system may be one of the neurobiological correlates of emotion dysregulation (ED). ED may play an important role in adolescent suicidal behavior. Some psychopathological conditions such as depression or childhood psychological trauma that increase suicidal risk in adolescents are also associated with HPA axis dysregulation. ED, a personality trait, can also be viewed as a predisposing factor that augments the vulnerability to suffer from psychiatric conditions.ConclusionsCorrelating HPA axis dysfunction with psychological factors such as ED could lead to a better understanding of the role of HPA abnormalities in adolescent suicide and may enhance preventive and treatment strategies.

Promoting voluntary help-seeking among doctors with mental disorders

ObjectivesTo explore if the Barcelona Integral Care Program for Doctors with mental disorders (PAIMM, in Catalan) has achieved its goal of enhancing earlier and voluntary help-seeking amongst sick doctors.Material and MethodsWe conducted a retrospective chart review of 1363 medical records of physicians admitted to the inpatient and outpatient units of the PAIMM from February 1st, 1998 until December 31st, 2011. The sample was divided into 3 time periods: 1998–2004, 2005–2007 and 2008–2011 (477, 497, and 389 cases, respectively).ResultsThe mean age at admission decreased (F = 77.57, p < 0.001) from the first period (

Differences in physicians' and nurses' recent suicide attempts: an exploratory study

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Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders

; SD = 10.28 years) to the last period (

Inpatient Physicians and Nurses With Dual Diagnosis: An Exploratory Study

\bar x = 44.81