Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide

A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow‐up (n = 168; 57%). Fifty‐three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide.     

A PSYCHOBIOLOGICAL REVIEW OF DEPRESSION DURING PREGNANCY

This paper argues that depression may be viewed as one of several normal affective developments of pregnancy rooted in some of the physiological events of gestation and that identification of depression during pregnancy may be difficult (but nonetheless important) because the symptoms of pregnancy and depression are confounded. Studies are reviewed that suggest variations in the incidence and course of depression during pregnancy, some biological bases for such depression when it occurs, some systems through which it might operate, and the possible need for biological and psychological interventions.