SUICIDE:
is the result of an act of self harm
deliberately initiated and
performed in the full knowledge or expectation of its Fatal Outcome.
Suicidal acts with nonfatal outcome are labeled by WHO as "Attempted Suicide”.
Derived from Latin word ,sui = oneself , cidium = a killing
Primary emergency for mental health professional
Major public health problem
More than 8,00,000 people die by suicide every year
Estimated annual mortality is 14·5 deaths per
1,00,000 people
Around one person every 40 seconds
75% of suicides occur in low- and middle-income countries
Tenth leading cause of death worldwide
It is the second leading cause of death in 15-29 year olds globally
suicide belt – (25 per 100,000) Scandinavia, Switzerland, Germany, Austria, eastern European countries (Belarus, Estonia, Lithuania, and the Russian Federation) and Japan
Prime suicide site of the world – Golden Gate Bridge in San Francisco
Japan- reported to have highest number of cases
Every year, more than 1,00,000 people commit suicide in our country. There are various causes of suicides like professional/career problems, sense of isolation, abuse, violence, family problems, mental disorders, addiction to alcohol, financial loss, chronic pain etc
According to NCRB:
A total of 1,39,123 suicides were reported in the country during 2019 showing an increase of 3.4% in comparison to 2018 and the rate of suicides has increased by 0.2% Scerotonergic system: low concentration of HIAA (metabolite of serotonin)
Non adrenergic system: stress-diathesis model
HPA axis: Dexamethasone suppression test- non-suppressors
Genetic:
Molecular biology – polymorphism in TPH gene
(tryptophan hydroxylase enzyme)
2019 over 2018.
Gender differences- Men 4 times > Women Exceptions – India and China , ratio is 1.3:1
Age- Increase with age
men peak age- after 45 years women – 55years
Physical health- loss of motility, Disfigurement, chronic intractable pain , patients on hemodialysis alcohol related illnesses
Mental illness
Previous h/o suicidal attempt
H/O Substance abuse
Marital status
Social isolation
Trouble coping with recent losses, death, divorce, moving, break-ups, etc.
Feelings of hopelessness and despair
Making final arrangements: writing a will or eulogy, or taking care of details (i.e. closing a bank account).
Gathering of lethal weapons
Giving away prized possessions
Preoccupation with death, such as death and/or 'dark' themes in writing, art, music lyrics, etc.
Sudden changes in personality or attitude, appearance, chemical use, or school behavior.Problem-solving
b) Psychotherapy
c) Distress-tolerance skills
d) Outreach
e) Provision of emergency cards
f)Antidepressants- fluoxetine, should be always combined with other therapies
b) Neuroleptics- flupenthixol 20mg for 6 months
c) Lithium
Family therapy
Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Center for Mental Health Services, also known as community mental health teams in the United Kingdom, support or treat people with mental disorders in a domiciliary setting, instead of a psychiatric hospital.
Biopsychosocial Model in Psychiatry- Revisited.pptxDevashish Konar
Over time our understanding of Psychiatric illnesses has undergone sea changes but yet the age old Bio-psycho-social model of etiology remains relevant. This presentation is an effort to explore the model in context of the newer developments.
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Suicide: Risk Assessment and InterventionsKevin J. Drab
Suicide: Risk Assessment and Interventions; assessing suicide; suicide; killing oneself; death by suicide; indirect suicide; dynamics of suicide; self-harm; suicide survivors; psychological autopsy; commonalities of suicide; protective factors suicide; suicide risk; suicide prevention; suicide prediction; risk factors suicide; suicide risk categories; Collaborative Assessment and Management of Suicidality (CAMS) method; Suicide Status Form (SSF); motivational interviewing and suicide; Common Errors of Suicide Interventionists; contracting for safety; completed suicide; died by suicide; suicide prevention; self injury; guns and suicide
Borderline personality disorder is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed borderline personality disorder as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.
Center for Mental Health Services, also known as community mental health teams in the United Kingdom, support or treat people with mental disorders in a domiciliary setting, instead of a psychiatric hospital.
Biopsychosocial Model in Psychiatry- Revisited.pptxDevashish Konar
Over time our understanding of Psychiatric illnesses has undergone sea changes but yet the age old Bio-psycho-social model of etiology remains relevant. This presentation is an effort to explore the model in context of the newer developments.
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Suicide: Risk Assessment and InterventionsKevin J. Drab
Suicide: Risk Assessment and Interventions; assessing suicide; suicide; killing oneself; death by suicide; indirect suicide; dynamics of suicide; self-harm; suicide survivors; psychological autopsy; commonalities of suicide; protective factors suicide; suicide risk; suicide prevention; suicide prediction; risk factors suicide; suicide risk categories; Collaborative Assessment and Management of Suicidality (CAMS) method; Suicide Status Form (SSF); motivational interviewing and suicide; Common Errors of Suicide Interventionists; contracting for safety; completed suicide; died by suicide; suicide prevention; self injury; guns and suicide
special thanks and acknowledgement goes out to the contributors of the slide:
meroshana, haziman fauzi, griselda pearl, widad ulya, atiqah shakira, halim latiffi, farith che man and marwan omar.
Hopefully this is able to help medical students to understand about the psychiatry topic, suicide.
This is made by students so if there are any mistakes, please do correct us. We are open to constructive criticism. thank you :)
It is a social philosophy of freedom, unfreeom, life, death & suicide. A PPT version of my paper "suicide as unfreedom & vice versa". Simpplified version of the paper.
Addiction and Suicide Prevention - December 2012 Dawn Farm
“Addiction and Suicide Prevention” was presented on Tuesday December 18, 2012; by Raymond Dalton, MA; Dawn Farm therapist. There is an alarmingly high prevalence of suicide among people with addiction and people in early recovery. This program will raise awareness of the signs of suicidal thinking and describe ways to offer support and obtain help for people who may be contemplating suicide. Viewers will learn how to recognize suicidal thinking, reach out and offer support to others contemplating suicide, obtain help when suicidal thoughts are present, and access local and national suicide prevention and intervention resources. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
A Psychiatric emergency is a disturbance in thought, mood or action which causes sudden stress to the individual or sudden disability, thus requiring immediate management.
Psychiatric emergencies are acute changes in behavior that negatively impact a patient's ability to function in his or her environment. ... The screening assessment also involves a psychiatric safety check to explore for suicidal ideation, homicidal ideation, or patients' inability to care for themselves.
In the 1980, to reduce the heterogeneity of schizophrenia, researchers tried to identify homogeneous subtypes in the hope to facilitate the identification of links between symptoms and The division of symptoms as positive or negative and categorization of schizophrenia as positive and negative subtypes became popular. However, researchers noticed that negative symptoms were not inherent to the disorder alone, but may also be due to neuroleptic medications, depression and environmental factors. This was shared by the concept of primary and secondary negative symptoms. To better understand primary negative symptoms, a separate subtype of schizophrenia, deficit and non-deficit schizophrenia was given by Carpenter.According to Carpenter et al. the term ‘deficit symptoms’ should be used to refer specifically to those negative symptoms that are present as enduring traits.
These deficit symptoms occur regardless of the patient's medication status and are not specifically responsive to anticholinergic drugs or antipsychotic drug withdrawal. It was further conceptualized that the presence of poor premorbid adjustment preceding initial psychotic episode may be manifestations of the deficit syndrome. In 2001, a review of the literature suggested that deficit schizophrenia is a disease separate from other, nondeficit forms of schizophrenia .
The proposal of a separate disease was based on the evidence that deficit and nondeficit schizophrenia differ on five dimensions typically used to distinguish diseases: signs and symptoms, course of illness, pathophysiological correlates, risk and etiological factors, and treatment response.Family history
Kirkpatrick et al reviewed studies showing that the deficit/nondeficit categorization has a significant concordance within families and that family members of deficit probands, compared with relatives of nondeficit probands, have more severe social withdrawal and an increased risk of schizophrenia.
Genetics
A few studies have examined the genetics of deficit and nondeficit schizophrenia, but the results have been disappointing.
Hong et al (6) reported that the dihydropyrimidinase-related protein 2 (DRP-2) gene was associated with risk for both deficit and nondeficit schizophrenia; however, after correcting for multiple comparisons, the association with nondeficit schizophrenia was not significant, and for deficit schizophrenia the association was present only for Caucasian but not African-American Deficit patients have a more severe course of illness than nondeficit patients, with a higher prevalence of abnormal involuntary movements before administration of antipsychotic drugs and poorer social function before the onset of psychotic symptoms.
The prevalence of deficit schizophrenia has been reported to be about 15% among patients with first-episode schizophrenia and 25%–30% among those with chronic schizophrenia
The risk factor of deficit patients differ from those of nondeficit patients. Deficit patients may a
Schizophrenia A chronic mental disorder involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.
Antipsychotic Agents Antipsychotic drugs are able to reduce psychotic symptoms in a wide variety of conditions, including schizophrenia, bipolar disorder, psychotic depression and drug induced psychosis. They have also been termed neuroleptics, because they suppress motor activity and emotionalityClinical Efficacy of Antipsychotic Drugs
Antipsychotic drugs are effective in controlling symptoms of acute schizophrenia, when large doses may be needed.
Long-term antipsychotic treatment is often effective in preventing recurrence of schizophrenic attacks, and is a major factor in allowing schizophrenic patients to lead normal lives.
Classification of Antipsychotic Drugs Typical antipsychotics Phenothiazines (Chlorpromazine, Perphenazine, Fluphenazine, Thioridazine) Thioxanthenes (Flupenthixol, Clopenthixol) Butyrophenones (Haloperidol, Droperidol)
Atypical antipsychotics (Clozapine, Risperidone, Sulpiride, Olanzapine, Aripiprazole)
Depot preparations are often used for maintenance therapy.
Approximately 40% of chronic schizophrenic patients are poorly controlled by antipsychotic drugs; clozapine may be effective in some of these ‘antipsychotic-resistant’ cases.
The dramatic outburst of Coronavirus disease (COVID-19) on the global stage has amazed many people and left us feeling vulnerable and helpless.The widespread outbreak of COVID-19 virus has brought not only the risk of death but also major psychological pressure
Understandably, there has been much emphasis on the effect of the pandemic on the health of the population, as well as the consequences of the potential loss of life from overwhelmed public health systems.
Mental retardation{intellectual disability} is a condition of arrested or incomplete development of mind, which is specially characterized by impairment of skills manifested during the developmental period, which contribute to the overall level of intelligence, i.e cognitive, language, motor and social abilities.
Prevalence of mental disorders is 4-5 times higher in person with intellectual disability
CAUSES-
GENETIC
ENVIORNMENTAL/SOCIO-CULTURAL
PRENATAL,PERINATAL AND POSTNATAL FACTOR
COMBINED Behavior management
Monitoring the child’s development needs & problems.
Programs that maximize speech, language, cognitive, psychomotor, social, self-care, & occupational skills.
Ongoing evaluation for overlapping psychiatric disorders, such as depression, bipolar disorder, & ADHD.
Family therapy to help parents develop coping skills & deal with guilt or anger.
Provide day schools to train the child in basic skills, such as bathing & feeding.
“Mindfulness" originates from the Pali term sati and in its Sanskrit counterpart smṛti.
Sati/ Smṛti originally meant "to remember" , "to recollect" , "to bear in mind“Formal mindfulness, most often referred to as meditation, involves intense introspection whereby one sustains one’s attention on an object (breath, body sensations) or on whatever arises in each moment (called choice less awareness).
Informal mindfulness is the application of mindful attention in everyday life. Mindful eating and mindful walking are examples of informal mindfulness practices. In fact any daily activity can be the object of informal mindfulness practice.
Non-meditation-based mindfulness exercises are specifically used in dialectical behavior therapy (DBT; Linehan, 1993) and acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
3. INTRODUCTION
• SUICIDE:
– is the result of an act of self harm
– deliberately initiated and
– performed in the full knowledge or expectation of its Fatal Outcome.
• Suicidal acts with nonfatal outcome are labeled by WHO as "Attempted Suicide”.
• Derived from Latin word ,sui = oneself , cidium = a killing
• Primary emergency for mental health professional
• Major public health problem
4. HISTORICAL PERSPECTIVE
• HISTORY-WORLD
• Finds a mention in the ancient treatises of all cultures
– New testament- Judas hanged himself after betraying Christ
– Christian church declared suicide as a form of murder as early as 6th century
– Zoroastrian philosophers call it a crime
– Early Greeks considered it acceptable
– Romans were against suicide
– Judaism considers it sinful
– Considered a moral and heroic act in certain situations (hara-kiri by Japanese samurais)
– Islam condemns it
5. HISTORY-INDIA
• In hindu mythology, death of Lord Rama led to mass suicides in Ayodhya
• Some parts of vedas emphasized suicide as a ritual
• Upanishads however have condemned it
• After war of Mahabharata, Yudhishtira thought of committing suicide
• Indian culture accepted suicide by certain groups- widows, terminally ill and aged at
holy places
• Sallekhana (devotee ending life by gradual starvation) in Jainism
• Sati and Johar practise was widely prevalent
6. HISTORY (CONTD.)
• Term ‘suicide’ was first used by Sir Thomas Browne in 1642 in his book Religio Medici
• Derived from ‘SUI’ (of oneself) and ‘CAEDES’ (murder)
• First scientific attempt started in 1763 with the work of Merian who emphasized that
suicide is a disease, not a sin or a crime
• In 1905, R Gaupp (psychiatrist) indicated that there were some peculiar and unique
personality traits among people committing suicide
7. GLOBAL SCENARIO
• More than 8,00,000 people die by suicide every year
• Estimated annual mortality is 14·5 deaths per
• 1,00,000 people
• Around one person every 40 seconds
• 75% of suicides occur in low- and middle-income countries
• Tenth leading cause of death worldwide
• It is the second leading cause of death in 15-29 year olds globally
• suicide belt – (25 per 100,000) Scandinavia, Switzerland, Germany, Austria, eastern European countries (Belarus, Estonia,
Lithuania, and the Russian Federation) and Japan
• Prime suicide site of the world – Golden Gate Bridge in San Francisco
• Japan- reported to have highest number of cases
8.
9. INDIAN SCENARIO
• Every year, more than 1,00,000 people commit suicide in our country. There are various
causes of suicides like professional/career problems, sense of isolation, abuse,
violence, family problems, mental disorders, addiction to alcohol, financial loss, chronic
pain etc
• According to NCRB:
• A total of 1,39,123 suicides were reported in the country during 2019 showing an
increase of 3.4% in comparison to 2018 and the rate of suicides has increased by 0.2%
during 2019 over 2018.
13. TIME OF SUICIDE:
• Most common during: Daytime (8 A.M.-5 P.M.) (Chavan BS et al, 2008)
• Second most common time: Early morning (Chavan BS et al, 2008)
• Other study reported equal incidence: Between day and night (Mohanty S et al,
2007)
14. ETIOLOGY
• Sociological Factors
• Durkheim’s Theory: Emile Durkheim ( French Sociologist 0
• Suicide – egoistic, altruistic, anomic
• — Egoistic - This type of suicide occurs when the degree of social integration is low
• — Altruistic - degree of social integration too high
• — Anomic – Integration into society is disturbed
15. BIOLOGICAL FACTOR
• Scerotonergic system: low concentration of HIAA (metabolite of serotonin)
• Non adrenergic system: stress-diathesis model
• HPA axis: Dexamethasone suppression test- non-suppressors
• Genetic:
• Molecular biology – polymorphism in TPH gene
• (tryptophan hydroxylase enzyme)
16. RISK FACTOR
• Gender differences- Men 4 times > Women Exceptions – India and China , ratio is 1.3:1
• Age- Increase with age
• men peak age- after 45 years women – 55years
• Physical health- loss of motility, Disfigurement, chronic intractable pain , patients on
hemodialysis alcohol related illnesses
• Mental illness
• Previous h/o suicidal attempt
• H/O Substance abuse
• Marital status
• Social isolation
17. BIOLOGICAL ,PSYCHOSOCIAL ,DEMOGRAPHIC FACTOR
Depression
,Schizophrenia Addiction
disorder Family history &
past history of suicidality
Dysregulated
serotonergic system
Older age Male sex
Vulnerable periods
Early parental
loss,Isolation
Unemployment
Acute life events
19. PROTECTIVE FACTOR
• Strong connections to family and community support
• Skills in problem solving, conflict resolution, and non-violent handling of disputes
• Personal, social, cultural and religious beliefs that discourage suicide and support self-
preservation
• Restricted access to means of suicide
• Seeking help and easy access to quality care for mental and physical illnesses
20. COMMON METHODS OF SUICIDE
• Pesticide poisoning(30%)
• Hanging
• Firearms
• Drug overdose
• Fatal injuries
• Exsanguinations
• Suffocation
• Drowning
22. TERMINOLOGIES
• — Parasuicide : injures themselves by self mutilation but do not wish to die
• — Cyber-suicide : suicide pact made between individuals who meet on the internet
• — Copycat suicide : a suicide within a peer group/publicized suicide can serve as a
model for next suicide in absence of sufficient protective factors (Werther syndrome)
• — Anniversary suicide: persons take their lives on the day a member of their family
did
23. WARNING SIGNS
• — Trouble coping with recent losses, death, divorce, moving, break-ups, etc.
• — Feelings of hopelessness and despair
• — Making final arrangements: writing a will or eulogy, or taking care of details (i.e.
closing a bank account).
• — Gathering of lethal weapons
• — Giving away prized possessions
• — Preoccupation with death, such as death and/or 'dark' themes in writing, art,
music lyrics, etc.
• — Sudden changes in personality or attitude, appearance, chemical use, or school
behavior.
24. TREATMENT
• Treatment of suicide attempters
• every completed case of suicide there are about 20 non fatal attempts
• Repetition – 15-25% within a year
• Poor problem solving skills
25. PSYCHOSOCIAL TREATMENT
• a) Problem-solving
• b) Psychotherapy
• c) Distress-tolerance skills
• d) Outreach
• e) Provision of emergency cards
• f) Family therapy
26. PHARMACOLOGICAL TREATMENT
• a) Antidepressants- fluoxetine, should be always combined with other therapies
• b) Neuroleptics- flupenthixol 20mg for 6 months
• c) Lithium
27. MANAGEMENT IN CLINICAL PRACTICE
• 1) Assessment- ( SAD PERSON’S scale – high specificity but low sensitivity so not
used anymore)
• 2) Treatment:
• a) Psychiatric disorders to be treated
• b) Community therapy- problem solving and outreach
• c) Adolescents – family therapy, group therapy
28. PREVENTION
• Strategies to reduce domestic violence provide poverty relief and improve treatment of mental and
physical disorders (Maselko J et al, 2008).
• Greater emphasis on educating the general public regarding the policies and services available for
suicide prevention.
– As the majority of the general population and all the subjects with attempted suicide were not aware of any
community and support services for the prevention of suicide (Manoranjitham S et al, 2007).
• Strategies involving restriction of access
– to common methods of suicide and need of specific measure at the probable time of crisis by government
agencies.
• School-based interventions involving
– crisis management, self-esteem enhancement and the development of coping skills and carrier counseling.
•
• In a multicentre study (India as one of the centre) by Fleischmann A et al (2008) reported that brief
intervention and contact (BIC) in the form of patient education and follow up than the usual mode of
treatment only
– Significantly effective method for prevention of suicides in suicide attempter. This is also a low cost method.