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Biomedical subjects

A J Kerkhof

Publications and source records attributed to A J Kerkhof.

At least 19 recordsLinked to original sources
PubMed2003

[Neuroticism in the elderly. The utility of the shortened DPQ-scales].

This article reports on the relation between aging and personal adjustment. Current personality scales are not developed for older persons. Scales contain items which are not valid for an aging population and contain too many items for administration in older populations. As part of the Longitudinal Aging Study Amsterdam (LASA) Neuroticism in older persons was measured with a shortened version of the Inadequacy (IN) and Social Inadequacy (SI) scales of the Dutch Personality Questionnaire (DPQ). The utility of these shortened scales was assessed based on internal consistency, inter-item correlations, test-retest reliability and factor analysis. The consistency of the personality dimension Neuroticism was assessed based on cohort-differences and a 6-year longitudinal comparison. The research-population contained 2118 respondents at baseline, aged between 55 and 85 years, 49% were male and they were not living in an institution. The shortened scales appeared to be reliable and valid instruments to measure Neuroticism in the elderly. The gaining of time due to the administration of the shortened scales enlarges the feasibility of the scales for measuring Neuroticism in older persons. Results showed no significant age-difference on the IN-scale, but revealed a significant difference on the SI-scale (p < .01). The 65+ elderly (65-74 and 75-85) have higher scores on Social Inadequacy than the youngest elderly (55-64). Longitudinal analyses showed an interaction between age at baseline and the stability and change of the level of Neuroticism. On both scales the youngest age-group showed a significant decline in mean level of Neuroticism (p < .01). The mean level of Social Inadequacy in the oldest age-group showed an increase during the 6-year follow-up period (p < .05). However, the differences were very small. Future research is needed to assess the effect of related variables on Neuroticism in older persons.

Age Factors↗
PubMed1999

Physical illness and parasuicide: evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO).

OBJECTIVE: The aim of this research was to identify psychosocial characteristics which might predict future suicidal behavior in parasuicidal subjects in Europe. METHOD: The interview utilized for the survey (European Parasuicide Study Interview Schedule--EPSIS) was administered to 1269 parasuicides aged fifteen years and over, within one week of hospital admission after a suicide attempt, and is part of a longitudinal multicenter study. EPSIS included a brief medical questionnaire, scales rating depression, hopelessness, self-esteem, suicide intention, questions on sociodemographic characteristics, an interview on life events and social support, a description of the parasuicidal act, and an evaluation of factors precipitating the index parasuicide. RESULTS: Physical illness proved to be very frequent among suicide attempters. One in two subjects suffered from an acute, chronic, or chronic disorder in relapse at the time of the parasuicide. Subjects with a physical illness were significantly more depressed, particularly subjects from the intermediate age band and ones affected by a chronic physical disease in relapse. Forty-two percent of patients with physical illness rated their somatic problem as a factor precipitating the attempt and 22 percent judged it to be major one. Furthermore, subjects with physical illnesses considered psychiatric symptoms and disorders to be relevant factors in triggering suicidal behavior, to a greater extent than non-sufferers. The importance of physical illness in contributing to suicidal behavior increased with advancing age. CONCLUSIONS: More careful attention to somatic conditions and their subjective implications would probably augment chances of effectively preventing suicide.

Adolescent↗
PubMed1998

Platelet serotonin, monoamine oxidase activity, and [3H]paroxetine binding related to impulsive suicide attempts and borderline personality disorder.

BACKGROUND: The aim of the present study was to examine the relationship between suicidal behavior and impulsiveness, and more generally borderline personality disorder on the one hand, and platelet indicators of central serotonergic function on the other. METHODS: After a suicide attempt platelet serotonergic measures were obtained from 144 patients with at least one previous attempt. A major DSM-III-R Axis I diagnosis and the use of antidepressants were reasons for exclusion. RESULTS: Platelet monoamine oxidase (MAO) activity was negatively correlated with the personality traits "multi-impulsive behavior" and "disinhibition." In accordance, platelet MAO activity was also lower in patients with less-planned suicide attempts. Platelet serotonin (5-HT) and recidivism were positively correlated with borderline personality disorder, in particular chronic feelings of emptiness. Platelet 5-HT was lower in patients with alcohol abuse. The maximum number of binding sites (Bmax) for paroxetine binding was positively correlated with "sensation seeking." CONCLUSIONS: These findings support the hypothesis that serotonergic involvement in impulsive suicidal behavior is mediated by the relationship between serotonergic function and impulsiveness as personality trait. Other borderline personality traits relevant to recurrent suicidal behavior, in particular chronic feelings of emptiness, appear also related to serotonergic measures.

Adolescent↗
PubMed1997

[Detoxication in opiate addiction and prevention of recurrence: administration of naltrexone and cognitive behavior therapy].

Rapid opiate withdrawal and relapse prevention in opiate addicts are made possible by naltrexone, clonidine and diazepam in combination with cognitive behavioural therapy according to the Community Reinforcement Approach. In an open pilot experiment 12 addicted patients achieved initial detoxification. At follow-up after a minimum of 6 months, 10 of these had not relapsed. Good results with this detoxification method could be booked by selecting highly motivated opiate addicts.

Adrenergic alpha-Agonists↗
PubMed1997

Platelet serotonin and [3H]paroxetine binding correlate with recurrence of suicidal behavior.

To distinguish state- from trait-dependent associations between serotonergic function and suicidal behavior, platelet serotonergic measures were repeatedly measured, during a 1-year follow-up, in 106 patients who had recently attempted suicide for at least a second time. A major DSM-III-R axis I diagnosis or use of antidepressants were reasons for exclusion. A higher affinity constant (KD) of platelet [3H]paroxetine binding was related to a higher risk of short-term recurrence of a suicide attempt, suggesting a state relationship. Higher levels of platelet serotonin at baseline were a significant predictor of a recurrent suicide attempt within the year of follow-up, suggesting a trait relationship. These associations held equally within the subgroup of 73 patients with a borderline personality disorder. Neither the maximum number of binding sites (Bmax) of [3H]paroxetine nor platelet monoamine oxidase activity correlated with suicidality. The observed association between indicators of platelet serotonin uptake and suicidal behavior suggests a state- and trait-dependency between suicidality and central serotonergic dysfunction.

Adolescent↗
PubMed1995

Background and introduction to the WHO/EURO Multicentre Study on Parasuicide.

In most European countries, suicidal behavior is a major public health problem and a considerable drain on resources at both the primary and secondary health care levels. Unfortunately, due to cross-cultural differences both in medical treatment of nonfatal suicidal behavior and in research methodologies, it has proved almost impossible to make valid comparisons between countries. It is therefore imperative that international studies based on the same definitions and methodologies be facilitated if we want to extend our knowledge of suicidal behavior and be able to make suggestions for intervention and prevention. The WHO Regional Office for Europe decided to support a collaborative multicenter study, designed to provide a reliable epidemiological picture of parasuicide in Europe. This article provides an introduction to the study.

Adolescent↗
PubMed1995

Medically treated suicide attempts: a four year monitoring study of the epidemiology in The Netherlands.

OBJECTIVE: The incidence of medically treated attempted suicides was investigated in a defined area in the western part of The Netherlands, and demographic groups at risk were identified. DATA AND METHODS: Suicide attempts treated at general hospitals, psychiatric hospitals, and in general practice were monitored between 1 January 1989 and 1 January 1993. Information on demographic characteristics of the subjects who attempted suicide and characteristics of the attempts was registered through a monitoring system and there was maximum coverage. Data on the general population in the catchment area were derived from national, regional, and municipal bureaux of statistics. RESULTS: The mean annual incidences of medically treated suicide attempts (events) were 95/100,000 for males and 155/100,000 for females. At risk groups for attempted suicide were the young (< 40 years); females; people who were divorced, unemployed, or disabled; or those who had low levels of education. CONCLUSIONS: Apart from general hospitals and psychiatric hospitals, 28% of all reported suicide attempts were reported exclusively by general practitioners, which supports the conclusion that they are an important source of information. There were indications that the number of medically treated suicide attempts in this area is stabilising.

Adolescent↗
PubMed1994

Mode of death and kinship in bereavement: focusing on "who" rather than "how".

Although it is widely accepted that bereavement can result in health problems, little is still known about the factors that determine the impact of the loss on those left behind. The Leiden Bereavement Study attempted to address this problem, by examining the consequences of bereavement after suicide (N = 91), traffic accident (N = 93), and illness (N = 125) for first-degree family members. Seventy-three bereaved spouses, 68 parents, 86 siblings, and 82 adults who had lost a parent were interviewed in a longitudinal time-sample study. Multiple measures of physical, psychological, and social functioning, as well as details about the relationship and pre- and post-loss events, were obtained through in-depth structured interviews at 4 and 14 months after the loss. The results indicate that the influence of mode of death is small to absent for most aspects of psychosocial health. Post-traumatic stress symptoms were almost as common among the illness-bereaved group as they were among the unnatural death groups. The kinship relationship to the deceased played a prominent role in virtually all aspects of functioning, with parents (particularly mothers), widowers, and sisters of the deceased being more strongly affected than adult children, brothers, and widows. The characteristics of the relationship played a further important role in the level of problems after the loss. Early adaptation was highly predictive of longer-term adaptation. The implications of the findings for prevention and intervention are discussed.

Accidents, Traffic↗