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Augustenborg, Sweden

Lapierre S.,University of Quebec at Trois - Rivieres | Erlangsen A.,University of Aarhus | Waern M.,Sahlgrenska University Hospital | de Leo D.,Griffith University | And 7 more authors.
Crisis | Year: 2011

Background: Suicide rates are highest among the elderly, yet research on suicide prevention in old age remains a much-neglected area. Aims: We carried out a systematic review to examine the results of interventions aimed at suicidal elderly persons and to identify successful strategies and areas needing further exploration. Methods: Searches through various electronic databases yielded 19 studies with an empirical evaluation of a suicide prevention or intervention program designed especially for adults aged 60 years and older. Results: Most studies were centered on the reduction of risk factors (depression screening and treatment, and decreasing isolation), but when gender was considered, programs were mostly efficient for women. The empirical evaluations of programs attending to the needs of high-risk older adults seemed positive; most studies showed a reduction in the level of suicidal ideation of patients or in the suicide rate of the participating communities. However, not all studies used measures of suicidality to evaluate the outcome of the intervention, and rarely did they aim at improving protective factors. Conclusions: Innovative strategies should improve resilience and positive aging, engage family and community gatekeepers, use telecommunications to reach vulnerable older adult, and evaluate the effects of means restriction and physicians education on elderly suicide. © 2011 Hogrefe Publishing. Source

Spinogatti F.,Community Mental Health Center | Civenti G.,Directorate General for Health | Conti V.,Regional Center for Pharmacovigilance | Lora A.,Lecco Hospital
Social Psychiatry and Psychiatric Epidemiology | Year: 2015

Purpose: To analyze the differences in mental health service utilization by immigrant and native populations of Lombardy, an Italian region that hosts one-fourth of the immigrants living in Italy. Method: The data are drawn from the regional mental health information system (based on the case register model), which supplies information on the users and mental health activities of the Departments of Mental Health, Lombardy, a region of about 10 million people; 139,775 adult users were treated in mental health services in 2010. Results: Mental health services are used by 11.3 immigrant users out of 1,000 immigrants (with marked differences depending on country of origin) compared with 17.0 native users. Acute mental health services are used more frequently by immigrant patients; the types of intervention provided to immigrants differ from those provided to the native population (mainly as far as psychotherapeutic interventions is concerned), while gender differences are substantial. Conclusions: The number of immigrant users using mental health services has increased notably in recent years, and in Lombardy it has been observed that the use of such services differs from service unit to service unit. This raises the problem of how to increase the cultural awareness of mental health professionals dealing with the mental health needs of the immigrant population. On the whole, immigrants use community mental health services less than the native population; however, immigrants tend to be more frequently admitted to general hospital psychiatric units during acute phases and both the utilization rates and gender differ greatly, depending on the country of origin. © 2014, Springer-Verlag Berlin Heidelberg. Source

Meulenbeek P.,VU University Amsterdam | Meulenbeek P.,Community Mental Health Center | Willemse G.,Trimbos Institute Netherlands Institute of Mental Health and Addiction | Smit F.,Trimbos Institute Netherlands Institute of Mental Health and Addiction | And 4 more authors.
British Journal of Psychiatry | Year: 2010

Background Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder. Aims This study (trial registration: ISRCTN33407455) was conducted to evaluate the effectiveness of an early group intervention based on cognitive-behavioural principles to reduce panic disorder symptomatology. Method Participants with subthreshold or mild panic disorder were recruited from the general population and randomised to the intervention (n = 109) or a waiting-list control group (n = 108). The course was offered by 17 community mental health centres. Results In the early intervention group, 43/109 (39%) participants presented with a clinically significant change on the Panic Disorder Severity Scale-Self Report (PDSS-SR) v. 17/108 (16%) in the control group (odds ratio (OR) for favourable treatment response 3.49, 95% Cl 1.77-6.88, P=0.001). The course also had a positive effect on DSM-IV panic disorder status (OR = 1.96, 95% C1=1.05-3.66, P=0.037). The PDSS-SR symptom reduction was also substantial (between-group standardised mean difference of 0.68). The effects were maintained at 6-month follow-up. conclusions People presenting with subthreshold and mild panic disorder benefit from this brief Intervention. Source

Drost L.M.,Community Mental Health Center | Schippers G.M.,University of Amsterdam
Clinical Child Psychology and Psychiatry | Year: 2015

From epidemiologic research, we know that children of parents with a mental illness (COPMI) have an elevated risk of developing a serious mental disorder. Aside from studies based on risk and resilience, there has been little research on the children's own perceptions. The aim of this study was to expand our understanding of key variables influencing COPMI's seeking support and to explore whether a website targeted at COPMI could help them improve their ability to cope with their circumstances and to find professional help. This case study illustrates one visitor's use of a website that was specifically designed to help COPMI. The visitor was a young adult female whose two parents both suffered from mental illness. She participated for 3 years in an intervention delivered through the website. Several things helped to inform us about her perspective on living with parents suffering from mental illness, her use of the website and the benefits she derived from using the website. These included (a) her story as she told it in the exit interview, (b) her messages to her peers and counsellors, (c) her user data and (d) the content of her chat conversations with her peers. © The Author(s) 2013. Source

Dickhaut V.,Community Mental Health Center | Arntz A.,Maastricht University
Journal of Behavior Therapy and Experimental Psychiatry | Year: 2014

Background and Objectives Schema Therapy (ST) is a highly effective treatment for Borderline Personality Disorder (BPD). In a group format, delivery costs could be reduced and recovery processes catalyzed by specific use of group processes. As patients may also need individual attention, we piloted the combination of individual and group-ST. Methods Two cohorts of BPD patients (N = 8, N = 10) received a combination of weekly group-ST and individual ST for 2 years, with 6 months extra individual ST if indicated. Therapists were experienced in individual ST but not in group-ST. The second cohort of therapists was trained in group-ST by specialists. This made it possible to explore the training effects. Assessments of BPD manifestations and secondary measures took place every 6 months up to 2.5 years. Change over time and differences between cohorts were analyzed with mixed regression. Results Dropout from treatment was 33.3% in Year 1, and 5.6% in Year 2, without cohort differences. BPD manifestations reduced significantly, with large effect sizes, and 77% recovery at 30 months. Large improvements were also found on general psychopathological symptoms, schema (mode) measures, quality of life, and happiness. Cohort-2 tended to improve faster, but there were no differences between cohorts in the long term. Limitations The study was uncontrolled, training effects might have been non-specific, and the sample size was relatively small. Conclusions Combined group-individual ST can be an effective treatment, but dropout might be higher than from individual ST. Addition of specialized group-ST seems to speed up recovery compared to only individual ST. © 2013 Elsevier Ltd. All rights reserved. Source

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