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Relatively little is known about midlife suicides, compared to adolescent and elderly suicides. A life-span model of suicidal behaviors is suggested as a heuristic conceptual tool. General midlife tasks and crises, as outlined by Levinson and Erikson, are reviewed. However, more than routine midlife developmental problems occur in most suicides. Some of the possible distinctive traits of midlife suicides (versus younger and older suicides) include: loss of spouse, years of heavy drinking, reaching the age of high depression risk, and occupational problems (including unemployment, inability to work, and retirement). Midlife suicide rates tend to be highest among white males, although female suicide rates peak in midlife. The paper concludes with a review of assessment and treatment issues related to a half-dozen high-risk midlife suicide types.  相似文献   
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ABSTRACT: The normal human condition is such that even with the best that life can offer suicide is understandable. Life is short, often painful, unpredictable, and lonely. In addition the lives of some individuals are in effect “suicidal careers” in that the harshness of normal life is combined for them with extra suicidal catalysts. Suicide makes sense. Minimally suicide resolves the life problem for the suicide. At the same time suicide is an impoverished self-transformation. Life, as trying and despairing as it can be, is still all we have. The suicide resolves the life problem by obliterating life itself, rather than by transforming self, history, and society. The suicide gives his or her life back inappropriately. In this sense no suicide is ever rational.  相似文献   
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The authors discuss the development of the concept of prevention as it has evolved from the public health and mental health fields. Concepts of epidemiology, treatment, and community mental health are defined in terms of their contributions to the evolution of prevention thinking. Four models of prevention are presented and critiqued: the public health model, the operational model, the antecedent conditions model, and the injury control model. Essential ingredients for implementing effective preventive interventions are presented, as well as examples of practical preventive interventions.  相似文献   
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The most common legal action involving psychiatric care is the failure to reasonably protect patients from harming themselves. In this regard it is critical to understand that courts have tended to impose much stricter standards on inpatient than on outpatient care; that at the present time, most malpractice actions involve clinical activities related to inpatient care (negligent admission, treatment, supervision, discharge, etc.). This article reviews the current climate in the legal and clinical formulation of standards of care for hospitalized adult suicidal patients. It suggests general guidelines for effective assessment, management, and treatment procedures that balance the need for high-quality care by a reasonable and prudent practitioner with the requirements of court-determined and statutory standards. The authors specifically discuss court cases that show common failure situations in inpatient care, discharge planning, and follow-up (e.g., problems in pharmacotherapy, the decision to hospitalize, the assessment of imminence and lethality, etc.). The paper also emphasizes the crucial element of clinical judgment in developing any inpatient standard of care.  相似文献   
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