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K Michel

Publications and source records attributed to K Michel.

At least 73 records · Page 4Linked to original sources
PubMed1994

A comparison of the drugs taken in fatal and nonfatal self-poisoning.

The objective of this study was a) to compare patterns of drug use in fatal and nonfatal overdoses and b) to find out if toxic drugs are overrepresented in overdoses with fatal outcome. A total of 179 cases of fatal overdoses in Switzerland (population 6.6 million) were compared with 269 medically treated self-poisoners from the agglomeration of Berne (population 301,630). Because of frequent multiple drug use, all the different compounds taken singly or in combination with other drugs were recorded and grouped according to drug types. The patterns of the frequencies of drugs used were remarkably similar in both groups. The majority of the drugs were psychotropics (81% in fatal and 68% in nonfatal overdose). Twenty-nine completed suicides were the result of drug combinations specifically recommended by EXIT. In the remaining cases benzodiazepines were used most frequently in both attempted and completed suicide, often in combination with other drugs or alcohol. Barbiturates were the only drugs recorded significantly more often in fatal overdoses (9% vs 3%). No significant difference was found for tricyclic antidepressants (13% vs 10%), or other types of drugs. The results are consistent with our assumption that drugs with higher toxicity would be overrepresented in overdoses with fatal outcome. Barbiturates, which are well known to be dangerous in overdose, were clearly associated with fatal overdoses, but not tricyclic antidepressants. This, in our view, suggests that the risk of prescribing tricyclic antidepressants should not be overestimated. The frequent use of benzodiazepines in completed suicide, however, indicates that there are no truly safe drugs in overdose.

Adult↗
PubMed1994

Understanding deliberate self-harm: the patients' views.

Patients were asked to explain why they had attempted suicide, by spontaneous description and by the use of lists of problems and motives presented to them. They were also asked what help they would have accepted before the event, and what the consequences of the suicide attempt were. The main motive for attempting suicide mentioned was an acute and unbearable state of mind. Interpersonal (manipulative) motives were of much less importance to the patients. In contrast, the problems which patients thought had an influence on what they had done were mainly interpersonal problems and, to a lesser degree, health problems. Especially younger individuals saw interpersonal difficulties as the main problems. Many patients reported that in the suicidal crisis they would not have been prepared to accept help. Most felt the suicide attempt had positive consequences for them.

Adolescent↗
PubMed1994

[Characteristics of young suicide attempters and their importance for helpers].

66 suicide attempters were interviewed with the European Parasuicide Study Interview Schedule (EPSIS) and characteristics of persons under the age of 26 were compared with those over 26.82% of the young suicide attempters gave interpersonal conflicts as reasons for their suicide attempts while most older persons gave psychiatric disorders as reasons. The younger group also had significantly lower scores on the Beck Depression Inventory and the Hopelessness Scale. While younger suicide attempters rarely had sought help from their GP within the month preceding the attempt one third of the older group had done so. It is concluded that in order to understand the reasons why people attempt suicide a differential approach combining the concept of crisis as well as the concept of illness is needed. Helpers should know that young suicide attempters rarely show signs of clear psychiatric disorder but usually attempt suicide because they are unable to cope with interpersonal conflicts.

Adolescent↗
PubMed1993

[Prescribing practice of psychotropic drugs in a psychiatric university clinic].

An investigation on the use of psychotropic drugs in a Swiss university psychiatric hospital shows that compared with other drug surveys drugs were prescribed to relatively fewer patients and polypharmacy was used in less than 50% of the patients. The most frequently administered drugs were neuroleptics, among which, surprisingly. Clozapine ranked first. Antidepressants were prescribed in relatively low doses. A drug survey like ours can provide a basis for the critical discussion of prescribing habits.

Adolescent↗
PubMed1992

Parasuicide in Europe: the WHO/EURO multicentre study on parasuicide. I. Introduction and preliminary analysis for 1989.

The WHO/EURO multicentre study on parasuicide is a new, coordinated, multinational, European study that covers two broad areas of research: monitoring trends in the epidemiology of parasuicide (epidemiological monitoring study); and follow-up investigations of parasuicide populations, with a view to identifying the social and personal characteristics predictive of future suicidal behaviour (repetition prediction project). This article provides background information on the development and organization of the multicentre study, and presents selected findings from the epidemiological monitoring project, based on a preliminary examination of data collected in 15 centres on parasuicides aged 15 years and over treated in health facilities in defined catchment areas during the year 1989. The overall parasuicide incidence varied considerably across the centres, from a high (event) rate of 414 per 100,000 males in Helsinki to a low of 61 among males in Leiden. The highest female event rate was 595 in Pontoise, and the lowest 95 in Guipuzcoa. The mean event rate across all centres was 167 among males and 222 among females. Parasuicide incidence tended to be elevated among 15- to 34-year-olds, with lowest rates among those aged 55 years and over. With one exception (Helsinki), the female parasuicide rate was higher than the male rate, the F:M ratio ranging from 0.71:1 to 2.15:1, with a median of 1.5:1 (events). Short-term repetition rates (as measured by the event:person ratio) differed between centres, from 1.03 to 1.30 (median = 1.12) among males, and from 1.07 to 1.26 (median = 1.13) among females. Although we warn against generalizing from our findings to make statements about differences in parasuicide between countries, we argue that the differences between centres are valid and should be addressed in further research.

Adolescent↗
PubMed1992

Suicide prevention: spreading the gospel to general practitioners.

General practitioners were trained in the recognition and treatment of suicide risk either by written text alone or combined with a seminar meeting. They filled in questionnaires before and after training. In the seminar group, knowledge and attitudes changed significantly, while those doctors receiving written material only had similar results to those without training.

Adolescent↗
PubMed1992

[Graduate education for psychiatry and psychotherapy specialty FMH: retrospective evaluation by the psychiatrist. 1].

Psychiatrists who recently finished their postgraduate training filled in a questionnaire about their training experiences. Two thirds considered the training as generally insufficient although many gave high ratings when asked about the quality of their clinical experiences and the acquisition of skills. It appears that the main areas for possible improvement of the training should concern knowledge and practical experiences with disorders which are typical for psychiatric out-patients.

Adult↗
PubMed1992

[Graduate education in psychiatry and psychotherapy specialty FMH: retrospective evaluation by psychiatrists. 2].

A questionnaire filled in by psychiatrists shortly after the end of their postgraduate training showed that the majority invested a considerable amount of time and money for a psychotherapy training on private initiative. Three quarters had a training analysis. About 70% felt that their private training efforts had been more important than the official psychotherapy training in the institutions. Psychiatrists working in institutions tended towards a more positive rating of the official postgraduate training.

Adult↗
PubMed1991

[Attemoted suicide in the Bern region].

In a European multicenter study all the suicide attempts in the city and agglomeration of Berne which came under medical treatment during a 12-month period were surveyed. There were 243 females and 153 males, corresponding to a rate of 177.1 and 128.6 per 100,000 respectively. The investigated region can be regarded as representative of Switzerland. Comparison with other centers shows that the incidence of attempted suicide in Switzerland--unlike that of suicide--is approximately in line with the European average. The usual method is overdose of drugs, in particular benzodiazepines. Nearly all the drugs involved in the overdoses were obviously prescribed by physicians. The choice of drugs suggests that many suicidal people deliberately take anxiety-and tension-reducing agents, a fact which points to a relationship between anxiety states and attempted suicide. Both are to be regarded as the expression of acute emotional stress and require an appropriate therapeutic approach.

Adolescent↗
PubMed1990

[Knowledge and attitude of the practicing physician about the theme of suicide].

A questionnaire was sent to general practitioners in order to evaluate their knowledge and attitudes about suicide and suicide prevention. Our hypothesis was that many physicians do not sufficiently recognize the medical dimension of this problem and that their knowledge is insufficient. The results show that the physicians are generally well aware of the medical dimension and thus of their potential role in the prevention of suicide. However, they do not feel competent in managing suicidal patients, and we found serious gaps in their knowledge. Most physicians showed interest in further training. In view of these results as well as the frequency of suicidal behaviour it appears clearly necessary to give more weight to the teaching of knowledge and skills of suicide prevention in medical schools.

Female↗
PubMed1989

[Reflections on the goals of post-graduate education in psychiatry].

The numerous tasks of psychiatry result in a long list of topics in the postgraduate-training. In Switzerland, the possibility of introducing postgraduate examinations in psychiatry are being discussed, in order to ensure minimal standards of training. This, however, would require clearly defined aims of the training. The present paper tries to open the discussion by proposing a list of learning items which should be required in the training of psychiatrists.

Curriculum↗
PubMed1987

Suicide risk factors: a comparison of suicide attempters with suicide completers.

Fifty cases of attempted suicide were compared with 50 cases of completed suicide on variables reported to measure suicide risk: the seriousness of the attempt, and the circumstances in which the act occurred discriminated best. Depressive symptoms were more frequent in the suicide group and in the serious attempters' group than in the non-serious attempters' group.

Age Factors↗