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13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study characterized rates and predictors of suicidal thoughts among HIV-infected persons living in rural communities of eight U.S. states. Self-administered surveys were completed by 201 HIV-infected persons living in communities of 50,000 or fewer that were located at least 20 miles from a city of 100,000 or more. All participants were clients of rural AIDS service organizations and had recently enrolled into a randomized clinical trial of a telephone-delivered, coping improvement-group intervention designed specifically for HIV-infected rural persons. At baseline, participants reported on thoughts of suicide, psychological symptomatology, life-stressor burden, ways of coping, coping self-efficacy, social support, and barriers to health care and social services. Thirty-eight percent of HIV-infected rural persons had engaged in thoughts of suicide during the past week. A logistic regression analysis revealed that participants who endorsed thoughts of suicide also reported more depressive symptoms (odds ratio [OR] = 2.19; 95% confidence interval [CI] = 1.32-3.63, p < .002), less coping self-efficacy (OR = 0.70; 95% CI = 0.56-0.88, p < .002), more frequently worried about transmitting their HIV infection to others (OR = 1.66, 95% CI = 1.14-2.40, p < .008), and experienced more stress associated with AIDS-related stigma (OR = 1.58, 95% CI = 1.07-2.35, p < .03). As AIDS prevalence rates increase in rural areas, interventions that successfully identify and treat geographically isolated HIV-infected persons who experience more frequent or serious thoughts of suicide are urgently needed.
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PMID:Thoughts of suicide among HIV-infected rural persons enrolled in a telephone-delivered mental health intervention. 1205 19

It is important for healthcare providers to have a clear understanding of sexual orientation and other components of sexual identity (genetic gender, anatomic gender, gender identity, gender role, and sexual behavior). Knowledge of how a lesbian identity is formed will aide providers in guiding these girls through adolescence. Societal stigma often forces isolation that leads to many risky behaviors that affect health (alcohol and drug use; risky sexual behaviors; truancy and dropping out; running away and homelessness; and depression and suicide). Health providers need to ensure a safe and understanding environment for these girls, to enhance their physical, emotional, and social development to healthy adulthood.
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PMID:Sexual orientation of adolescent girls. 1242 80

The published literature provides strong evidence for connections between mental health issues, such as depression, and suicidal behaviours. However, in spite of this, no investigations to date have explored young people's perceptions of the interconnections between depression, and suicidal behaviours. This article presents discussive analyses of discussions of the contributions of depression to their suicidal behaviours of young people in New Zealand. Two dominant discourses of depression emerged: a medicalised discourse, and a moral discourse. The medicalised discourse was accessible to the majority of participants, and constructed depression as a disease. This discourse prioritised the voices of health professionals and suggested that depression was difficult to resist. The moral discourse was an alternative to the medicalised discourse, and constructed young people who experienced depression and suicidal behaviours as failures. Both discourses were informed by a mechanistic cause-and-effect relationship between depression and suicidal behaviours: attempting suicide was seen as an inevitable outcome of experiencing depression, and suicidal behaviours were inevitably undertaken by young people who were depressed. Resistance to either of these dominant discourses was problematic, and was best articulated during discussions of the stigma associated with mental ill-health and depression.
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PMID:Problematising depression: young people, mental health and suicidal behaviours. 1276 9

This brief historical overview of bipolar disorder addresses diagnosis, treatment, cost, creativity, suicide, and stigma with a review of the literature. This served as the introduction to the 27th Annual Scientific Meeting of the American Academy of Clinical Psychiatrists (51 references).
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PMID:The ups and downs of bipolar disorder. 1293 65

Human immunodeficiency virus (HIV) infection has become a pandemic concern for many nations. When this disease first presented itself in a global manner in the early 1980s, it was accompanied by fear, denial, misunderstanding, social stigma, and a paucity of available support services. The U.S. Army was becoming increasingly aware of the potential impact HIV could have on the active forces. A tragic event involving the suicide of a young HIV-infected soldier resulted in the development of a comprehensive medical/psychosocial assessment and treatment program for HIV-infected service members and their families at the Walter Reed Army Medical Center. Social work services played an integral role in the development of this program as this profession has done historically in meeting other emerging needs of the military. Special attention is given to the unique psychosocial issues and needs of the HIV-infected service member and the comprehensive and compassionate response of the military medical team with its significant social work contribution.
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PMID:Human immunodeficiency virus social work program at the Walter Reed Army Medical Center: a historical perspective. 1452 41

In the ethnographic study on which this article is based, the authors investigate experiences after a suicide attempt from the perspective of patients and their family members in Taiwan. Thirty-four patients and 49 family members or colleagues participated in interviews from the point of patients' hospitalization to their return to the community. The postsuicide stigma suffered by patients and their families was based on such cultural themes as Suicide is bu-hsiao (non-filial piety), Suicide results in an inability to transmigrate the soul, and Suicide is inherited. Patients, family members, and colleagues cope with the stigma through explaining suicide as due to "bad luck" or "a kan-huo (hot energy) problem," or by insisting that it was "not a true suicide." These findings suggest that health professionals can move closer to patients and their families and suggest appropriate health care policy through understanding the patient's and the family's explanation of suicide experiences.
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PMID:The cultural context of suicide stigma in Taiwan. 1501 2

One of the delineating elements found in suicide bereavement versus normal bereavement is the stigma experienced by survivors. This review of the literature will provide insight into stigma as an underlying element in suicide bereavement and point to the role of health professionals in dealing with this complex issue. Historical review and empirical studies are analyzed to provide a framework for how suicide relates to natural bereavement. The conclusion is that suicide bereavement is different from natural loss. The challenge to health care providers is to sort through the complex issues surrounding the individual and their social network to find mechanisms that lead to resolution. Suicide has a profound effect on the family, friends, and associates of the victim that transcends the immediate loss. As those close to the victim suffer through bereavement, a variety of reactions and coping mechanisms are engaged as each individual sorts through individual reactions to the difficult loss. Bereavement refers to "all the physiological, psychological, behavioral, and social response patterns displayed by an individual following the loss (usually through death) of a significant person or thing" (Dunne, Dunne-Maxim & McIntosh, 1987). Bereavement following suicide is complicated by the complex psychological impact of the act on those close to the victim. It is further complicated by the societal perception that the act of suicide is a failure by the victim and the family to deal with some emotional issue and ultimately society affixes blame for the loss on the survivors. This individual or societal stigma introduces a unique stress on the bereavement process that in some cases requires clinical intervention.
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PMID:Do suicide survivors suffer social stigma: a review of the literature. 1582 48

This study investigated educational needs of female injecting heroin users in Taiwan relating to HIV/AIDS prevention via six focus group discussions in a prison. All sessions were audio-taped with respondents' consent and the discussions transcribed verbatim. The findings indicated that respondents had adequate knowledge about HIV/AIDS, but held misconceptions regarding the modes of HIV transmission. Many respondents who did not perceive themselves susceptible to AIDS rarely used condoms and occasionally shared needles. Stigma surrounding AIDS is pervasive among respondents and they considered contracting cancer would be preferable to having AIDS; the latter could precipitate suicide. Lastly, many respondents had no confidence in assurances of confidentiality regarding HIV testing. Issues of misconceptions, high-risk behaviors, stigma surrounding AIDS and confidentiality of HIV testing must be addressed in appropriate HIV/AIDS education programmes with respect to the needs of female injecting heroin users.
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PMID:Using focus groups to investigate the educational needs of female injecting heroin users in Taiwan in relation to HIV/AIDS prevention. 1599 76

Mental disorders cause more disability than any other class of medical illness in Americans between ages 15 and 44 years. The suicide rate is higher than the annual mortality from homicide, AIDS, and most forms of cancer. In contrast to nearly all communicable and most non-communicable diseases, there is little evidence that the morbidity and mortality from mental disorders have changed in the past several decades. Mental health advocates, including psychiatric researchers, have pointed to stigma as one of the reasons for the lack of progress with mental illnesses relative to other medical illnesses. This review considers how the expectations and goals of the research community have contributed to this relative lack of progress. In contrast to researchers in cancer and heart disease who have sought cures and preventions, biological psychiatrists in both academia and industry have set their sights on incremental and marketable advances, such as drugs with fewer adverse effects. This essay argues for approaches that can lead to cures and strategies for prevention of schizophrenia and mood disorders.
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PMID:Cure therapeutics and strategic prevention: raising the bar for mental health research. 1635 50

Fifty years ago adolescents mostly died of natural causes, whereas they now die from more preventable causes. Part of this change has been a worldwide rise in adolescent suicide rates in both developed and developing countries. Suicides are probably under reported due to cultural and religious stigma attached to self-destruction. Objectives of this study were to collect data about suicidal thoughts, plans and attempts and related sociodemographic details in high school students. The population comprised 2,480 randomly selected students among 46,271 students from 72 high schools in 1999-2000 in Adana and 2,352 (94.8%) students from 10 schools were reached and given a questionnaire modified using Youth Risk Behavior Survey Questionnaire (YRBSQ). Chi2 and Kolmogorov-Smirnov tests were used. Mean age was 16.5 +/- 1 (14-21) year, 1,187 (50.5%) students reported severe desperation, 526 students (22.4%) had suicidal thoughts, 332 (14.1%) planned committing suicide, 145 (6.2%) attempted suicide. The occurrence rate of desperation, suicidal thoughts, plans, attempts and the mean number of attempts were significantly higher in females than males. Adolescent suicide is a tragedy affecting individual, family, peers, and community. Families, teachers, and physicians should be aware of risk factors for suicide.
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PMID:Suicidal thought and behavior in high school students in Adana, Turkey. 1641 56


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