1. Mental Disorders and Suicide Kathryn Corley Advanced General Psychology PSY492 XC Mary Viventi Saturday, August 14, 2010
2. Abstract Even in today’s world, there is still so much to be learned about the relationship between suicide and mental disorders. Archival data obtained from institutions provide information that will help draw conclusions between the correlations between suicide and certain mental disorders. Specifically this research study will attempt to see if there is a stronger relationship between depression and suicide than between bipolar or schizophrenia and suicide.
3. Research Question Are patients who are clinically diagnosed with major depression are more likely to attempt suicide than patients diagnosed with bipolar disorder or schizophrenia?
4. Suicide & Depression Prediction of suicide attempt with 75% success rate Aggressiveness of treatment correlates with suicide rate Method of suicide attempt related to treatment Depressive symptoms related to suicidal ideation
5. Suicide vs Bipolar Disorder & Schizophrenia Stage in bipolar disorder compared with suicide attempt rate 15% of those with Schizophrenia risk of death by suicide Provide better treatment by understanding all the risks involved Suicide prevention priority for all disorder treatments, not just depression
6. Procedures Data obtained from archival information at institutions Only data from those who suffer from depression, bipolar, and schizophrenia Suicide attempt rate analyzed versus the mental disorder
7. Ethical Considerations Confidentiality Research relayed in mature manner Institutional Review Board to review study Consent forms for institutions Discuss relevance of the study Entire process outlined Where questions and concerns can be directed
8. References (1981, June). Depression and suicide. Research Resources Reporter, pp. 10-12. (2005). Suicide Among Youth - Which Mental Disorders Are Responsible?: Diagnosis and treatment should address all disorders and not just focus on depression. Washington, District of Columbia, US: American Psychological Association, Public Information and Media Relations; Public Affairs Office. (2006). Statistics on Depression. Chicago, Illinois, US: Depression and Bipolar Support Alliance. Brådvik, L., & Berglund, M. (2005). Suicide in severe depression related to treatment. European Archives of Psychiatry & Clinical Neuroscience, 255(4), 245-250. doi:10.1007/s00406-004-0553-7. Galfalvy, H., Oquendo, M., & Mann, J. (2008). Evaluation of clinical prognostic models for suicide attempts after a major depressive episode. ActaPsychiatricaScandinavica, 117(4), 244-252. doi:10.1111/j.1600-0447.2008.01162.x. Gibb, B., Andover, M., & Miller, I. (2009). Depressive characteristics of adult psychiatric inpatients with a history of multiple versus one or no suicide attempts. Depression & Anxiety (1091-4269), 26(6), 568-574. doi:10.1002/da.20412. Gonda, X., Fountoulakis, K., Kaprinis, G., & Rihmer, Z. (2007). Prediction and prevention of suicide in patients with unipolar depression and anxiety. Annals of General Psychiatry, 623-8. Retrieved from Academic Search Complete database. Johnson, J., Gooding, P., & Tarrier, N. (2008). Suicide risk in schizophrenia: Explanatory models and clinical implications, The Schematic Appraisal Model of Suicide (SAMS). Psychology & Psychotherapy: Theory, Research & Practice, 81(1), 55-77. doi:10.1348/147608307X244996. Pompili, M., Amador, X., Girardi, P., Harkavy-Friedman, J., Harrow, M., Kaplan, K., et al. (2007). Suicide risk in schizophrenia: learning from the past to change the future. Annals of General Psychiatry, 610-22. doi:10.1186/1744-859X-6-10. Valtonen, H., Suominen, K., Haukka, J., Mantere, O., Leppämäki, S., Arvilommi, P., et al. (2008). Differences in incidence of suicide attempts during phases of bipolar I and II disorders. Bipolar Disorders, 10(5), 588-596. doi:10.1111/j.1399-5618.2007.00553.x.
Editor's Notes
The thought process that occurs in individuals just prior to attempting suicide would be a fascinating topic to study. However, in the cases where suicide attempt is successful, it can be quite difficult to discern the exact thoughts, feelings, emotions, and behaviors that led up to this final act even when a note is left behind. In recent years, there seems to have been an increasing number of people who attempt suicide in the news. One’s right to end his or her own life is a controversy all its own. However the purpose of this study is to examine the relationships between suicide and other mental disorders. Typically, it is assumed that those who attempt suicide are those who suffer with depression, but this is not always the case. There are various other mental disorders that have significant suicide statistics. The goal of this project is to determine if depression is the disorder with the highest percentage of attempted suicide, or if bipolar and schizophrenia disorders have a similar rate of suicide attempts. Are patients who are clinically diagnosed with major depression more likely to attempt suicide than patients diagnosed with bipolar disorder or schizophrenia? This goal of this project is to determine if depression is the disorder with the highest percentage of attempted suicide, or if bipolar and schizophrenia disorders have a similar rate of suicide attempts. Are patients who are clinically diagnosed with major depression are more likely to attempt suicide than patients diagnosed with bipolar disorder or schizophrenia? It is anticipated that the results will find that although the suicide attempts among bipolar disorder and schizophrenia are significant, but attempts among those who suffer with depression will be higher.
Various articles have been found that address the suicide rates of those who suffer with depression. Galfalvy, H., Oquendo, M., & Mann, J. (2008) were able to evaluate major depressive participates to predict suicide attempts with a 75% success rate. Gonda, X., Fountoulakis, K., Kaprinis, G., & Rihmer, Z. (2007) found that aggressive treatment is optimal when treating those with depression in order to decrease the risk of suicidal behavior. Brådvik, L., & Berglund, M. (2005) studied the use of suicidal methods to see if the treatment used for the patients was related to the method of suicide attempted. They evaluated the characteristics associated with suicide and the rate of use of antidepressants as a lethal drug overdose. Gibb, B., Andover, M., & Miller, I. (2009) found that those with the depression symptoms of suicidal ideation had a higher rate of suicidal attempts than those who suffered from hopelessness or dysfunctional symptoms. Although not all people who suffer from major depression commit suicide, many do have suicidal thoughts or tendencies. It would be easy to assume that depression has the highest rates of suicide because it is simple to assume that one would want to end the negative mood by causing one’s life to end. However not everyone who commits suicide had been diagnosed with major depression. This is a significant study to examine because it may be possible that therapists do not classify those of other mental disorders as having a high risk for suicide than their patients diagnosed with depression. Knowing and understanding the suicide risk for their clients is essential for adequate coverage of possible side effects of mental disorders.
Several articles have been published that address the suicide rates of those who suffer with bipolar disorder. Valtonen, H., Suominen, K., Haukka, J., Mantere, O., Leppämäki, S., Arvilommi, P., et al. (2008) found that in bipolar patients, suicidal attempts vary depending on the stage one is in during the course of mood swings associated with this disorder. Those who suffer with schizophrenia have a 5-15% risk of death by suicide as found by research compiled by Pompili, M., Amador, X., Girardi, P., Harkavy-Friedman, J., Harrow, M., Kaplan, K., et al. (2007). It is important to understand the risks involved so as to provide better suicide prevention treatment for those who suffer from schizophrenia. Within the APA press release, Suicide Among Youth (2005), it is suggested that suicide prevention should be a priority for all disorder treatments and not just those who suffer from clinical depression.
The variables that will be used within this study are the type of mental disorder that is exhibited by those who are studied. The three disorders under evaluation are depression, bipolar disorder and schizophrenia. The second variable is suicide attempts. Whether or not the attempt of suicide was successful is irrelevant, because either way, it was still an attempt.Because of the nature of this research question, it would be unethical to utilize experimental research. Instead, archival data will be obtained from willing research facilities and therapists. There will not be a singular location where these statistics will be obtained. It would be wise to attempt to obtain statistics from all over the country, so that the population is well represented. The population of this study will be those who suffer from depression, bipolar disorder and schizophrenia within the United States. The total numbers of these people will be compared with the number those who have attempted or succeeded in suicide. This will supply the researchers with a percentage of those with the mental disorder that have attempted suicide.The articles used for research on this topic provided valuable knowledge on the measurement scales available to measure severity of a mental disorder. The researcher will need to rely on the therapists that have diagnosed the participant subjects that are involved in this study. It is not up to the researcher to further analyze the diagnosis that the participant has received, but to use the information provide to evaluate the percentage of suicide attempts of those who suffer with one of the three aforementioned disorders.ProceduresArchival information will be obtained from a number of institutions throughout the country. Specifically only the information from those who suffer from depression, bipolar disorder, and schizophrenia will be collected. Within the data received the variable that will be analyzed is if that particular person has attempted (or succeeded) suicide, or not. This will allow the researcher to calculate a percentage of those who have a disease who have attempted suicide. Examining to see if there is a stronger correlation or relationship between depression and suicide than between bipolar or schizophrenia and suicide will analyze the data. If the rate of suicide attempts is higher for those who suffer with depression than the average percentage of attempts for bipolar and schizophrenia, then we will know that depression does in fact have a higher rate of suicidal behavior. However if the opposite is proven true, then perhaps follow up studies ought to be performed to see which mental disorders need special attention to suicidal tendencies.
Ethical considerationsAn ethical consideration to be aware of is that suicide is very sensitive, difficult, and controversial area to study. The researcher needs to be certain to stick with the facts and figures, and not get caught up in the individual case studies. It is also quite important that the information received through this research is relayed in a mature manner. The Institutional Review Board will need to review the study requested to ensure that it meets their standards. This will make sure that no one’s rights are violated for the purpose of this study. Even though the researcher will not be interacting with individuals directly, it would be wise to supply an informed consent form for the institutions that are offering their information. The first part of this informed consent form is to provide information about the nature of the study being performed (Shaughnessy, Zechmeister, & Zechmeister, 2009, p. 69). The next important step is to inform why participation is important. Another part of informed consent is to inform the institution of all of the factors that may be expected to have an influence over the willingness to participate. The procedure of the study is also another important part of an informed consent form that will be important to the institution. The explanation of the entire process must be carefully outlined in plain language so as to not confuse those reading the form. It is crucial to not attempt to deceive the institution on the informed consent form, as this would be highly unethical, and may present major problems in the future. There ought to be a section as part of the informed consent form that tells the institution where their questions or concerns can be directed. Finally, the person signing the consent form must have the opportunity to receive a copy of the form for their future reference.
