Suicide Prevention Day Resources

The International Association for Suicide Prevention (IASP) and the World Health Organization (WHO) are co-sponsoring World Suicide Prevention Day on September 10th. The theme of this 11th anniversary event is “Stigma: A Major Barrier for Suicide Prevention.”

World Suicide Prevention DayAccording to the WHO and the latest Burden of Disease Estimation, suicide is a major public health problem in high-income countries and is an emerging problem in low- and middle-income countries. Suicide is one of the leading causes of death in the world, especially among young people. Nearly one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. These staggering figures do not include nonfatal suicide attempts which occur much more frequently than deaths by suicide.

A large proportion of people who die by suicide suffer from mental illness. Recent estimates suggest that the disease burden caused by mental illnesses will account for 25% of the total disease burden in the world in the next two decades, making it the most important category of ill-health (more important than cancer or heart diseases). Yet a significant number of those with mental illnesses who die by suicide do not contact health or social services near the time of their death. In many instances there are insufficient services available to assist those in need at times of crisis.

This lack of access to appropriate care is one of the many factors that magnify the stigma associated with mental illness and with suicidal ideation and behaviour. This type of stigma, which is deeply rooted in most societies, can arise for different reasons. One of the causes of stigma is a simple lack of knowledge – that is, ignorance. This type of stigma can be directly addressed by providing a range of community-based educational programs that are targeted to specific subgroups within the society (that is, by age, educational level, religious affiliation, and so forth). The goal of such programs is to increase public awareness of the characteristics and treatment of people with mental illnesses and/or suicidal behaviour, and of the available treatment resources to help individuals with these problems.

But knowledge is not enough to combat stigma. Negative attitudes about individuals with mental illnesses and/or suicidal ideation or impulses – prejudice – is common in many communities. These negative attitudes often do not change with education about mental illnesses and suicidal behaviour. Indeed, many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes about such patients. This can result in a failure to provide optimal care and support for persons in crisis. Changing such prejudicial attitudes requires a long-term effort to change the underlying cultural values of the community and a parallel effort to alter the treatment norms of health care professionals.

Stigma is also the underlying motive for discrimination – inappropriate or unlawful restrictions on the freedoms of individuals with mental illnesses or suicidal behaviour. Such restrictions can occur at a personal, community or institutional level. One extreme example is the criminalization of suicidal behaviour, which still occurs in many countries. Discrimination can prevent or discourage people affected by mental illnesses and/or suicidal ideation or behaviour from seeking professional help or from returning to their normal social roles after receiving treatment for an episode of illness or crisis. Clearly, criminalization of suicidal behaviour can be a powerful deterrent on the care-seeking of individuals in crisis who desperately need to be able to access care and support, without being judged or penalized.

At a government or administrative level, stigma can have an impact on resource allocation. In both high-income and low- and middle-income countries stigmatized conditions such as mental illnesses and suicidal behaviour receive a much smaller proportion of health and welfare budgets than is appropriate, given their huge impact on the overall health of the community. Furthermore, fund-raising efforts to support public health initiatives in this area often fall flat because of lack of interest among communities, governments, and international funding agencies; that is, because of stigma.

Attempts to fight stigma, by undertaking massive public education programs, have been of limited effectiveness in reducing the stigma associated with mental illness and suicide. New, innovative methods that are more target-group specific or that creatively use the emerging social media need to be developed and tested. Despite the difficulty and complexity of fighting stigma, persons, organizations and governments committed to the dual goals of improving the quality of life of individuals suffering from mental illnesses and suicidal ideation and of reducing the huge burden of suicide on families and communities don’t have an option. Unless stigma is confronted and challenged, it will continue to be a major barrier to the treatment of mental illnesses and to the prevention of suicide.

World Suicide Prevention Day provides a special opportunity to refocus our collective energies on addressing this fundamental problem. Changing cultural attitudes about mental illness and suicidal behaviour requires a scientific awareness of the many forces that influence community norms and the concerted effort of a wide range of community stakeholders over a prolonged period of time. World Suicide Prevention Day is an ideal time to inspire people to work towards the goal of developing creative new methods for eradicating stigma. Comprehensive local or national plans for the prevention of suicide will not reach their full potential until the problem of stigma is effectively addressed.

On this year’s World Suicide Prevention Day, IASP is hosting its first core activity, which will be to undertake a collective Cycle Around the World, with the aim to globally raise awareness of suicide and its prevention, and to reduce the stigma associated with it. Further details of this activity will be published on the IASP website on a regular basis over the coming months.

WHAT YOU CAN DO TO SUPPORT WORLD SUICIDE PREVENTION DAY

Become a Facebook Fan of the International Association for Suicide Prevention (IASP) www.facebook.com/IASPinfo

WORLD SUICIDE PREVENTION DAY is an opportunity for all sectors of the community – the public, charitable organizations, communities, researchers, clinicians, practitioners, politicians and policy makers, volunteers, those bereaved by suicide, other interested groups and individuals – to join with the International Association for Suicide Prevention and the WHO to focus public attention on the unacceptable burden and costs of suicidal behaviours with diverse activities to promote understanding about suicide and highlight effective prevention activities.

Those activities may call attention to the global burden of suicidal behaviour, and discuss local, regional and national strategies for suicide prevention, highlighting cultural initiatives and emphasizing how specific prevention initiatives are shaped to address local cultural conditions.

Initiatives which actively educate and involve people are likely to be most effective in helping people learn new information about suicide and suicide prevention.

Source: http://www.iasp.info/wspd/index.php

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Final DSM 5 Approved by American Psychiatric Association

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Final DSM 5 Approved by American Psychiatric AssociationYesterday, the board of trustees of the American Psychiatric Association (APA) approved a set of updates, revisions and changes to the reference manual used to diagnose mental disorders. The revision of the manual, called the Diagnostic and Statistical Manual of Mental Disorders and abbreviated as the DSM, is the first significant update in nearly two decades.

Disorders that will be in the new DSM-5 — but only in Section 3, a category of disorders needing further research — include: Attenuated psychosis syndrome, Internet use gaming disorder, Non-suicidal self-injury, and Suicidal behavioral disorder. Section 3 disorders generally won’t be reimbursed by insurance companies for treatment, since they are still undergoing research and revision to their criteria.

So here’s a list of the major updates…

Overall Changes to the DSM

According to the American Psychiatric Association’s statement, there are two major changes to the overall DSM — the dumping of the multiaxial system, and rearranging the chapter order of disorders. Most clinicians only paid attention to Axis I and II, so it’s no surprise the Axis system was never a big hit. The current chapter order has always been a bit of a mystery to most clinicians, so it’s good to know there’s some thought going into the new order of chapters.

Chapter order:

DSM-5’s 20 chapters will be restructured based on disorders’ apparent relatedness to one another, as reflected by similarities in disorders’ underlying vulnerabilities and symptom characteristics.

The changes will align DSM-5 with the World Health Organization’s (WHO) International Classification of Diseases, eleventh edition (ICD-11) and are expected to facilitate improved communication and common use of diagnoses across disorders within chapters.

Removal of multiaxial system:

DSM-5 will move to a nonaxial documentation of diagnosis, combining the former Axes I, II, and III, with separate notations for psychosocial and contextual factors (formerly Axis IV) and disability (formerly Axis V).

Specific Disorders

Autistic disorders will undergo a reshuffling and renaming:

“[Autism] criteria will incorporate several diagnoses from DSM-IV including autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified) into the diagnosis of autism spectrum disorder for DSM-5 to help more accurately and consistently diagnose children with autism,” according to an APA statement Saturday.

The rest of this update comes from the APA’s news release on the changes:

Binge eating disorder will be moved from DSM-IV’s Appendix B: Criteria Sets and Axes Provided for Further Study to DSM-5 Section 2. The change is intended to better represent the symptoms and behaviors of people with this condition.

This means binge eating disorder is now a real, recognized mental disorder.

Disruptive mood dysregulation disorder will be included in DSM-5 to diagnose children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.

The diagnosis is intended to address concerns about potential over-diagnosis and overtreatment of bipolar disorder in children. Will children now stop being diagnosed with bipolar disorder, which has been a recurring concern among many clinicians and researchers? We will see.

Excoriation (skin-picking) disorder is new to DSM-5 and will be included in the Obsessive-Compulsive and Related Disorders chapter.

Hoarding disorder is new to DSM-5.

Its addition to DSM is supported by extensive scientific research on this disorder. This disorder will help characterize people with persistent difficulty discarding or parting with possessions, regardless of their actual value. The behavior usually has harmful effects — emotional, physical, social, financial and even legal — for a hoarder and family members.

Pedophilic disorder criteria will remain unchanged from DSM-IV, but the disorder name will be revised from pedophilia to pedophilic disorder.

Personality disorders:

DSM-5 will maintain the categorical model and criteria for the 10 personality disorders included in DSM-IV and will include the new trait-specific methodology in a separate area of Section 3 to encourage further study how this could be used to diagnose personality disorders in clinical practice.

Posttraumatic stress disorder (PTSD) will be included in a new chapter in DSM-5 on Trauma- and Stressor-Related Disorders.

DSM-5 pays more attention to the behavioral symptoms that accompany PTSD and proposes four distinct diagnostic clusters instead of three. PTSD will also be more developmentally sensitive for children and adolescents.

Removal of bereavement exclusion:

The exclusion criterion in DSM-IV applied to people experiencing depressive symptoms lasting less than two months following the death of a loved one has been removed and replaced by several notes within the text delineating the differences between grief and depression. This reflects the recognition that bereavement is a severe psychosocial stressor that can precipitate a major depressive episode beginning soon after the loss of a loved one.

Specific learning disorder broadens the DSM-IV criteria to represent distinct disorders which interfere with the acquisition and use of one or more of the following academic skills: oral language, reading, written language, or mathematics.

Substance use disorder will combine the DSM-IV categories of substance abuse and
substance dependence. In this one overarching disorder, the criteria have not only been combined, but strengthened. Previous substance abuse criteria required only one symptom while the DSM-5’s mild substance use disorder requires two to three symptoms.

The APA board of trustees also outright rejected some new disorder ideas. The following disorders won’t appear anywhere in the new DSM-5:

  • Anxious depression
  • Hypersexual disorder
  • Parental alienation syndrome
  • Sensory processing disorder

Although clinicians are “treating” these concerns, the board of trustees felt like there wasn’t even enough research to consider putting them in Section 3 of the new DSM (disorders needing further research).

So there you have it. What do you think about these final decisions for the DSM-5?

 

Read the full list of changes from the APA: American Psychiatric Association Board of Trustees Approves DSM-5 (PDF)

Read the full article: Psychiatric association approves changes to diagnostic manual

Source: http://psychcentral.com/blog/archives/2012/12/02/final-dsm-5-approved-by-american-psychiatric-association/

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Alzheimer’s Disease Researchers Switch Focus to Prevention Methods

By Melinda Smith

Alzheimer's Disease Researchers Switch Focus to Prevention MethodsWhen scientists look back to the first quarter of the 21st century, they may marvel at what was accomplished in the treatment and prevention of Alzheimer’s Disease. Alzheimer’s is the most common form of dementia and is reaching global proportions. The World Health Organization says more than 35 million people now live with dementia and that number is projected to double by the year 2030.

As people live longer, there is growing pressure to develop a drug or vaccine that stops dementia.

Health and Human Services Secretary Kathleen Sebelius says setting priorities and coordinating research now will save time later.

“We’ve made the first historic investment of funds and a 15 year commitment to prevention and treatment,” she said.

In the past, the disease could be diagnosed only by doing an autopsy after the patient died.

Alzheimer’s researcher Ronald Petersen says new methods now can provide evidence while the patient is still alive.

“We use biomarkers, various imaging tests, blood tests, spinal fluid tests that are going to tell us that these are in fact indicators of what the disease is going to be,” he stated.

In images provided by the Banner Alzheimer’s Institute in Phoenix, Arizona, you can see the progression of the disease.

Inside the brain of an aging patient, the dark areas are formed by plaques – made up of the amyloid protein – and tangles – composed of another protein called tau. The result is a loss of brain cells and neurons responsible for memory and learning.

During a national summit last month on Alzheimer’s research, two promising clinical trials generated a lot of interest. In this trial, patients already showing signs of Alzheimer’s are given nasal syringes of insulin that push the drug into the neurons of the brain.

“Nearly three-quarters of participants showed improvement in memory over the four-month period, a 50 percent improvement,” said Dr. Suzanne Craft, who is in charge of the study..

But another study may promise earlier treatment to actually prevent the disease. Two years ago, New York Times reporter Pam Belluck and a photographer traveled to Colombia to visit an extended family afflicted by early onset Alzheimer’s. Approximately one-third carry a genetic mutation that brings on the disease while they in their ’30s and ’40s. Belluck says the healthier, older generation, often cares for younger victims.

“They may be bedridden. They need to be fed. They may need to be diapered. They’re also agitated,” Belluck spoke with VOA via Skype.

Early next year, a team of American scientists and Colombian doctors will begin a five-year clinical trial of more than 3,000 members of the family. Not all of the patients carry the genetic marker and some will get a placebo.

The head of the American team, Dr. Eric Reiman, says the immunization drug being tested is designed to clear the amyloid quickly from the brain.

“If we intervene sufficiently early before the disease has ravaged the brain, we think these treatments might have their best shot of having a profound effect,” he said.

Pam Belluck says the Colombian family members are anxious for something – or someone – to help them. Facing a grim future, many say they are willing to step forward if it will help them and future generations.

Source: http://www.voanews.com/content/alzheimers-disease-researchers-switch-focus-to-prevention-methods/1147372.html

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