Psychiatric, physiological, behavioral and self-report measures in relation to a suicide attempt

• Published in: Journal of psychiatric research 1971-06, Vol.8 (2), p.127-137
• Main Authors: Platman, S.R., Plutchik, R., Weinstein, Bette
• Format: Article
• Language: English
• Subjects: Affect; Anxiety; Behavior Therapy; Bipolar Disorder - blood; Bipolar Disorder - therapy; Depression; Female; Hostility; Humans; Hydrocortisone - blood; Middle Aged; Psychiatric Status Rating Scales; Pulse; Social Isolation; Suicide
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/0022-3956(71)90014-8

This paper describes a series of changes that took place in a depressed patient prior to and following a suicide attempt. Since this was being studied on a research ward, unique information was available regarding her plasma cortisol level and other physiological states, her daily behavior as noted by nurses, and her own ratings of her emotional states. Regular psychiatric ratings were also made. One of the striking findings of the study was a continuing increase in plasma cortisol over a 6-week period prior to the suicide attempt and a rapid return to normal levels after it. Another important observation was the high correlation between the psychiatrists' ratings of several affect states with nurses' ratings of affect based on overt behavior. Psychiatrists' ratings also correlated positively with several self-report indices obtained from the patients However, the psychiatrists' ratings of anxiety did not correlate well with the nurses' estimates of anxiety or the patient's self-reports of anxiety, suggesting the possibility that psychiatrists use this term in a way which is different from the way nurses or patients use it. The hypothesis is proposed that a group of affective and physiological states increase the likehood of suicide. These are: high depression and hostility, feelings of social isolation and low anxiety, and high plasma cortisol levels in the blood.