We evaluated the difference in sleep skills between patients with and without need of hypnotics after sleep CBT.

Total 131 insomnia patients' sleep disturbances were assessed by visual analogue scales. Patients received 9 sessions of sleep CBT and were prescribed hypnotics for prn during 3 months. Sleep CBT was focused on the sleep hygiene and sleep stimulus-control guidelines. Sleep hygiene guidelines were Limit the time spent in bed (SH1), Get regular exercise (SH2), Avoid light at night (SH3), Avoid heavy meals or drinking (SH4), Quiet, dark, and comfortable bedroom (SH5), Avoid caffeine, alcohol, and nicotine (SH6), Relaxing bedtime routine (SH7),Llight bedtime snack (SH8), Remove the bedroom clock (SH9). Sleep stimulus-control guidelines were Go to bed only when sleepy (SSC1), Use the bed for sleeping or sex (SSC2), Get out of bed when unable to sleep (SSC3), Get up at the same time (SSC4), Avoid napping (SSC5). Each sleep skill state was evaluated by Likert scale, and they were compared between before and after CBT. Patients were divided into two groups: still need of hypnotics and no need of hypnotics after 3 months.

Forty-six (35.1%) patients replied they needed not hypnotics any more, but 85 (64.9%) patients replied they still needed hypnotics after CBT. Sleep VAS (25.26±8.52 vs. 32.64±8.95, p<0.001), SH2 (3.67±0.92 vs. 2.76±1.06, p=0.030), SH7 (4.08±0.55 vs. 2.76±0.76, p<0.001) were different in two groups.

Among several CBT skills, regular moderate exercise in daytime and a relaxing bedtime routine seem to be key components.

Sleep hygiene can be described as practices to ease sleep and to avoid factors which decrease sleep quality. Inadequate sleep hygiene generally results in disturbance of daily life activities due to inability to sustain sleep quality and daytime wakefulness. The aim of the study was to assess psychometric properties of the Sleep Hygiene Index in clinical and non-clinical Turkish samples.

Data were collected from 106 patients with major depression and 200 were volunteers recruited from community sample who were enrolled at the university. The Sleep Hygiene Index (SHI), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were administered to the subjects. All depression patients and thirty-two healthy volunteers underwent a twenty-day test-retest procedure. Factor structure of the SHI was evaluated with explanatory and multi-sample confirmatory factor analyses. Pearson product-moment correlation coefficients of the SHI with the PSQI, ISI and ESS were performed. Item analyses, internal consistency coefficients and intra-class correlations between two repeated applications in both patient and healthy subjects were calculated.

Cronbach's alphas for the SHI in community sample and patients with major depression were 0.70 and 0.71, respectively. Scale scores had comparatively good temporal stability over a three-week time for either clinical or non-clinical samples. SHI had good internal reliability.

The findings of this present study suggest that the SHI may be a useful research or clinical assessment tool for evaluating sleep hygiene to guide case formulation, treatment planning in depression as well as nonclinical population.

The circadian disturbance associated with night-shift work is a source of occupational hazard that has a negative impact on the physical and mental health of workers.

Explore the sleep disorders and the psychological impact among night workers.

A cross-sectional study carried on 35 employees in an industrial company . It uses a questionnaire exploring the socio-professional data, psychological effects (fatigue, sleep, anxiety and depression) and family impact of the night work.

The following scales were used:

1. – SPIEGEL questionnaire to screen for sleep disorders.

2. – EPWORTH Sleepiness Scale to evaluate daytime sleepiness.

3. – PICHOT‘s fatigue scale to assess the intensity of fatigue.

4. – HAD scale: Hospital Anxiety and Depression scale.

The overage of the workers was 32.3 ± 6.7 years. Most of them (85%) were male.

The level education was superior in 74% of cases. Two thirds of employees work at night.

Among night workers, frequent nocturnal awakenings and sleep onset difficulties were noted in respectively 65% and 35% of cases.

Nearly three-quarters of subjects had anxiety symptoms and nearly a third had depressive symptoms.

Night workers complained mainly of impaired concentration (74%) and memory impairment (52%). Excessive fatigue was identified in 17, 4% of cases.

At the family level, 65% of subjects reported that night work cause disruption of their family life and of their quality of life.

Sleep disorders, anxiety and depression disorders are frequently found in night work. Besides, working the shift night can affect family life and the quality of life as well.

Individuals who differ markedly by chronotype, i.e., morning-type or evening-type, differ on a number of psychological, behavioral, and biological variables. Disruption in the usually integrated functions of consciousness, memory, identity and perception is definitional to dissociation, particularly pathological forms of dissociation. Dissociative experiences possess dream-like properties, which might be fueled by a labile sleep-wake cycle. Our study aimed to investigate the effects of individual biological rhythm differences on sleep quality and daytime sleepiness in conjunction with dissociative experiences.

Participants were 372 undergraduates, ranged between 18 and 26 years of age, 61.6 % were females.

The volunteers completed a package of psychological instruments including the Morningness–Eveningness Questionnaire, Dissociative Experiences Scale, Insomnia Severity Index, and Epworth Sleepiness Scale.

We performed mediation regression analysis of relations between dissociative symptomatology and chronobiological features mediated by insomnia and sleepiness. We run a multiple mediator model utilizing from the SPSS script in which we bootstrapped 5000 times.

We found direct effect of the MEQ scores on the DES scores was not substantial. Direct effect of the MEQ on the ESS was not significant; whilst the direct association between the ESS and the DES was significant (β=0.79; p<.01). Evening-type individuals were more prone to insomnia (β=-0.14; p<.01) and insomnia was a direct predictor of dissociative symptomatology (β=0.47; p<.01). Eveningness was significantly associated through insomnia with dissociation (β=-0.07; p<.01). The multiple mediator model is illustrated in Figure 1.

We found significant associations of pathological dissociation in terms of DES-taxon with insomnia and sleepiness.

A study that aims to evaluate some variables that can influence the sleep disorders.

It is a descriptive, observational and transverse study that pretends to investigate diverse psychopathologycal aspects and sleep disorders in patients diagnosed of depressive syndrome, in follow-up for an ambulatory service of mental health by means of a battery of widely recognized tests.

In the first consultation in addition to clinical evaluation of our investigation team, we have used questionnaires in relation to 136 socialdemographic, demanding of consultation and clinical – therapeutic variables. Likewise, we have applied the following battery of tests: BDI, HARS, WHOQOL-BREF, CGI and PSQI.

To comparative effects we have established two groups using the Pittsburg Sleep Quality Index:

Group 1: Score 0-8 (disturbance mild)

Group 2: Score >8 (disturbance moderate/severe).

84 patients initially evaluated by the different tests, 59 female and 25 male.

GROUP 2: 51 patients (60,71%): 39 female (76,47%) and 12 male (23,53%)

= Variables with higher scores showing a significant difference compared to group 1 have been: Married, Suicidal ideation, Abuses substances, Somatic diseases, Headache, Alteration memory and Dizzines.

= Tests PSQI 11,41 and in all domains: Quality 2,16, Efficiency 1,35, Latency 0,96, Disturbances 2,14, Daytime Dysfunction 1,95 and Use of Sleeping Medication 2,75.

60,72% of depressed patients with the high scores in the PSQI test (>8), and poorer quality of sleep, are those in our study have more gravity in the symptoms of depression, anxiety, somatization and quality of life more severe involvement.

The effect of poor sleep quality on depressive symptoms has been consistently found. The aim of our study was to assess the heterogenity of sleep quality in relations between circadian preferences and depressive symptomatology among major depression patients.

The sample was consisted of 225 patients with first diagnosis major depression. Mean age of the sample was 29.92 (SD±10.49). The patients completed a package of psychological instruments including the Morningness–Eveningness Questionnaire, Pittsburgh Sleep Quality Index, and Beck Depression Inventory.

The latent structure of sleep quality among first diagnose major depressive patients was examined by applying latent class analysis (LCA) to the seven components of the PSQI, using Mplus 4.01. We also examined the latent structure of sleep quality in conjunction with the MEQ and BDI scores.

We found that evening-type depressive patients were more prone to report greater scores of subjective sleep quality, sleep latency, sleep duration, use of sleep medication and daytime dysfunction sub-scales of the PSQI. Direct effect of evening-type chronobiological preference was significantly linked to greater depression scores. Indirect effects of chronobiological characteristics through components of the PSQI were only significant for use of sleep medication and daytime dysfunction sub-scales of the PSQI (p<.05).

These findings suggest that sleep quality in general operates and influences on depression in concert with chronobiological characteristics; however, the construct of sleep quality appear like to be heterogeneous in nature and is influential on severity of depression symptoms through distinct mechanisms among depressive patients.

Suicidal behaviour is one of the most common reasons for presentation to the emergency rooms. Perhaps the most frequently examined topic in the field of suicidology, is the degree to which death by suicide can be predicted. Moreover, some suicide risk factors may not be included consistently in the suicidal risk assessments in the emergency room.

Understand the suicide risk predictors that are most important in decision making in the emergency room, risk factors that often get missed in the emergency room assessments

We aim to use the results of this study to implement educational intervention that gears towards improving suicidal risk assessment and documentation in emergency room.

An online survey was sent to all psychiatry and emergency physicians at Queen's university to assess their opinion on predictors of suicide while assessing patients. The importance of predictors was compared between 2 groups. In addition charts of all patients assessed for suicide risk were reviewed. Suicide predictors assessed, the clinical decision made and the suicide predictors missed at the time of assessment, were recorded.

Our study shows that although there is a significant links between bullying and childhood trauma, and suicidal behaviour, these predictors were not commonly assessed. The result of our study also shows that many predictors deemed important by physicians are missed on actual assessment.

Our study shows that many important suicidal risk factors are missed in emergency room assessments. It is important that physicians identify these risk factors while assessing suicidality.

In this research both mental conditions before the death and 5 most frequent cases of suicide that resulted in death for the last 10 years are studied.

Current research, which is based on reports of forensic medical expertise and pathological anatomy center of Armed Forces, shows that among all suicide cases registered between 2002-2011 – 18 types are described in ICD-10; 5 types are studied.

Statistical analysis of suicide cases resulted in death for 10 years is dramatically high. Among military personnel X72-X74 are the first with 75%. Overall, 77,3% of all suicides are soldiers (officers 61,1%). All commited suicide cases registered among those who are frequently in the battle position and guard service. During the investigation, it is determined that 87,2% are those who committed suicide shooting to body's skull, 11,6% to chest and 1,2% to various areas of body. X70 – are second suicide attempts through self-hanging with 20,5%. All suicide cases among the soldiers – 19,5% (officers–22,2%). Other suicide cases are X60-X61, X63-X64, X68-X69–3,0%, X78–2% and X84–1%. During the retrospective analysis, it is determined that depressive violations before suicide was 73,4%, affective violations was 9,7% and 17,9% were other kinds of violations.

Every fourth suicide committed with a weapon; each third — during the daily duty or guard. The responsiveness to the state of mind of orderlies and guards – indispensable conditions to prevent suicide. It's necessary to establish regular service monitoring for every soldier, to hamper the distribution of daily duty to take its course.

is to study social and psychological characteristics of the college students committed suicidal attempts.

420 randomized students aged 15-23 (261 males and 159 females) from Chita were examined. The subjects committed suicidal attempts (31 students) were enrolled in the 1st group, the 2nd group included students who had not committed suicidal attempts. The prevalence of addictions and neurotic disorders were studied. The significance of differences was determined by Student criterion.

7,4% of students were revealed to have committed suicides before, with the majority being females (p<0,001). 48,8% of the students committed suicidal attempts were up brought in two-parent families, 32,3% live in poor conditions (p<0,05), 22,6% of the subjects have unfilial behavior. 16,1% of students' parents have alcohol addiction. The students of the 1st group were revealed to have a high frequency of different addictions compared with the control group: smoking – 67,7% and 40,1% (p<0,01); the use of drug – 51,6% and 21,1% (p<0,001); alcohol disorders (F10.1, F10.2) – 22,6% and 5,7% (p<0,05). The students of the 1st group (66,7%) have neurotic disorders compared with the control one (p<0,001).

Thus, the students committed suicidal attempts live more frequently in poor conditions, have tendency to addictive behavior and suffer from generalized anxiety, depressive, asthenic and hysterical disorders.

High suicide rates in the former Soviet Slavic republics (fSSr) Russia, Ukraine, Belarus and its profound fluctuations over the past decades have attracted considerable interest. There is suggestion that mass privatization as an economic strategy was a crucial determinant of differences in mortality trend in post-communist countries during transition.

We investigated whether population drinking can account for the fluctuations in suicide mortality in the fSSr Russia, Ukraine and Belarus during the recent decades.

Trends in overall and sex-specific age-adjusted suicide mortality rates and recorded alcohol consumption per capita from 1980 to 2010 were analyzed.

The temporal pattern of suicide mortality fluctuations were similar for three countries: sharp decrease in the mid-1980s, dramatic increase in the first half of the 1990s and downward trend in the past decade. Russia experienced the sharpest suicide mortality fluctuations during anti-alcohol campaign and transition. In Russia, there was also a spike in suicide mortality between 1999 and 2001, which might be explained by the financial crisis in 1998. The results of the time-series analysis suggest that the dramatic mortality fluctuations in the fSSr in the mid-1980s and in the first half of the 1990s were attributable to alcohol. In contrast, alcohol can not fully explain the downward trend in suicide mortality observed in the fSSr during the last decade.

Similar regional pattern of suicide trends do not support the hypothesis that alcohol control policy was responsible for the decline in Russian suicide mortality during recent decade.

Suicide completers have often communicated their intention to die or their deep desperation to their loved ones.

We retrospectively collected data on the suicide victims of the period 2007-2009 from the Athens Greater Area and completed psychological autopsy questionnaires after phone interviews with the victims' relatives. The specific question was: 'Has your relative expressed to you his/her suffering or the intention to end his/her life the six months prior to the suicide?'

Data on this parameter were collected for 248 victims -out of a total of 335. 121 of them (48.8%) had verbally communicated their intention to die -or their immense suffering- to their relatives. Suicide 'warners' used phrases indicating extreme desperation being often very descriptive about their intentions. They were older (p<0.001), more often had positive psychiatric history (p=0.004) or were physically ill (p=0.005) in comparison to 'non-warners'. Differences regarding sex, nationality, marital status, previous attempts, suicide note-leaving, completed suicide method and hospitalization for physical illness the year prior to the suicide were not statistically significant among the two groups. A limitation of our study is that we interviewed only one relative for every case. It is probable that the suicidal feelings could have been communicated to another relative instead, therefore rising the number of suicide 'warners'.

Relatives are keen observers of the suicidal feelings of their loves ones, a piece of information that health professionals should not miss. This fact, coupled with the particular characteristics of the suicide 'warners', could provide valuable insights for suicide prevention.

Antiepilepticsand benzodiazepines have been associated with increased risk of suicidality. However, in previous studies the severity of depression and anxiety have not been takeninto account as possible confounders.

To find out how antiepileptics and benzodiazepines effect suicidal ideation andother symptoms in general population.

To assessthe association between use of antiepileptics or benzodiazepines and suicidalideation in relation to other symptoms of depression and anxiety. Theassociation will be studied in different diagnostic groups in a largepopulation-based cohort.

Information on the prescribed medications in the Northern Finland Birth Cohort1966 was collected at the age of 31 years with a postal questionnaire(N=8,211). The presence of suicidal ideation and other symptoms of depressionand anxiety was assessed via the Symptom Checklist –questionnaire. Theassociations between medications and suicidal ideation were studied indifferent diagnostic groups: epilepsy, depression, any non-organic mentaldisorder, and control group.

There were no difference in suicidal ideation between antiepileptic users(n=54) and non-users (n=8,157) (suicidal ideation mean 1.07 vs. 1.05, p=0.63). Subjectsusing benzodiazepines (n=147) had more suicidal ideation than non-users(n=8,064) (1.29 vs. 1.05, p<0.001). The antiepileptic and benzodiazepineusers had more other depression and anxiety symptoms. When adjusting for thesesymptoms, both antiepileptic and benzodiazepine users had less suicidalideation than non-users. This was found in all diagnostic groups.

Either use of antiepileptics or benzodiazepines wasnot associated with increased suicidal ideation when symptoms of depression andanxiety were taken into account.

To investigate suicide rates in the indigenous (Nenets) and non-indigenous populations of the Nenets Autonomous Okrug (NAO) in 2002-2012 with associated socio-demographic characteristics.

Retrospective population-based mortality study.

Data from autopsy reports were used to identify 252 cases of suicide in the NAO in 2002-2012. Data on socio-demographic characteristics were obtained from passports and medical records and linked to population data from the Censuses. Suicide rates for the Nenets population and the non-indigenous population were calculated according to different socio-demographic characteristics. Corresponding relative risks for each population group were compared.

The crude standardized suicide rates were 72.7 per 100 000 person-years in the Nenets and 50.7 per 100 000 person-years in the non-indigenous population. The highest suicide rates in the Nenets population were observed in the age group 20-29 years and in females aged 30-39 years. Socio-demographic characteristics associated with high suicide rates for the Nenets were 20-39 years of age, male gender, urban residence, having secondary school or higher education, being an employee or employer, and being single or divorced. Males aged 20-29 years and females aged 30-39 and aged 70 years or over had the highest suicide rates in the non-indigenous population. The higher suicide rates in the non-indigenous population were associated with male gender, rural residence, secondary school education, being an employee or employer, and being single or divorced.

Suicide rates in the NAO were higher among the indigenous Nenets population than the non-indigenous population, and were associated with different socio-demographic characteristics.

Suicidality is a serious social problem. There is a limited evidence of pharmacotherapeutic options, therefore cognitive-behavioral therapy (CBT) and dialectical-behavioral therapy (DBT) play the crucial role in treatment of suicidal patients.

The search covered databases Web of Science and Pub Med. Search was limited by the years 1990 to 2013.

Main psychotherapeutic strategies in acute phase are based on intervention; making contact, identification of the stressors and developing of therapeutic relationship. The most important aspects of CBT approach concern teaching the patient how to understand stimulus of suicidal behaviour, how to control emotions and search for the reasons to live. DBT has proven its effectiveness in coping with emotional lability, which can lead to suicidal behaviour. The basic DBT principles include stress tolerance, emotional regulation and interpersonal effectiveness.

Despite the frequent use of CBT in the treatment of suicidal patients, the evidence of effectiveness from the studies of this approach is not sufficient enough. Problem solving strategies have been confirmed as effective. DBT proved to be successful in the treatment of suicidality of borderline personality disorder.

Previous suicide attempts and self-harm behaviors are one of the risk factors most strongly associated with suicide. Further, the risk of a fatal repetition of a suicide attempt is highest in the period immediately following the attempt, with a percentage between 12 and 30% during the first year.

Performing a literature review of articles published about telephone contact as a method of prevention of recurrence after a suicidal attempt.

To present an overview of telephone contact as a strategy to prevent repetition of suicidal behaviors.

The literature review was produced using the computerized database PubMed from January 1966 to June 2014, using Spanish- and English-language limits and the key words: Telephone contact, suicide attempt, self-harm.

There have been found a total of 5 studies which met the inclusion criteria, only one of them has obtained a significant reduction in the proportion of patients who repeated the suicidal attempt compared to the control group. In another study, the intervention has proved to be effective preventing suicide.

Although it could be a useful and inexpensive strategy, further investigation is needed in order to specify and improve the medium and long term efficacy of this intervention as a method of prevention from repetition of self-harm and suicide.

Cyclothymic-depressive-anxious-irritable (CDAI) temperament has been linked to increased suicidal risk. Sleep disturbance and short self-reported sleep duration have been associated with suicidal ideation and behavior independently of a current major depressive episode (MDE).

This cross-sectional study in consecutive hospitalized suicide attempters aimed to investigate the interplay of temperament with proximal sleep disturbance in predicting suicide intent.

Depression severity was measured with Major Depression Inventory, whereby DSM-IV-TR diagnosis of current MDE was derived. Temporally proximal sleep disturbance (during ≥2 weeks preceding the attempt) was assessed with Athens Insomnia Scale (AIS); average night sleep duration (ANSD) was also self-reported. Suicidal intent was recorded with Beck's Suicide Intent Scale (BSIS). Attempters’ temperament profile was investigated with TEMPS-A self-report questionnaire. A two-step cluster analysis of TEMPS-A subscales mean scores was performed. BSIS was sequentially regressed on AIS and ANSD along with their interactions with temperament clusters after adjusting for clinicodemographic variables and current MDE.

114 subjects (57.9% females), aged 16-87 (44.1±17.7) years were included. 50% reported previous attempts. 38.6% were currently depressed. 62.3% suffered from insomnia (AIS score ≥6); 42.1% slept ≤5 hours per night on average. Cluster analysis identified a CDAI group and a non-CDAI one. In multiple regressions, BSIS was independently associated with current MDE, CDAI temperament profile, AIS (beta=0.43, p=0.004) and ANSD (beta=-0.40, p=0.002). Significant interactions of temperament cluster with AIS (p=0.017) and ANSD (p=0.011) were recorded.

Temperament profile interacts with proximal insomnia and short self-reported sleep duration in predicting suicidal intent in recent attempters.

Suicidal attempts and suicidal ideation are both frecuent causes of phychiatric assessments in an emergency hospital based unit.

The aim was to determine socio-demographic variables and pshychiatric diagnosis associated with suicide attempts in the population admitted to the Emergency Room of a General Hospital in Spain.

We studied the prevalence of suicidal behaviour in patients assesed in the Emergency Room of Elche University Hospital (Alicante, Spain) during a period of a year. We studied different characteristics such as age, sex, association with abuse substance, the prevalence of admission to a psychiatric ward and psychiatric diagnosis associated.

A third of Hospital Psychiatric Emergency assessments were for suicide attempt or suicide ideation. Emergency Psychiatrists assessed 262 patients with suicide attempt, 91 male and 171 female, mean age was 31 years. 7,25% of the parasuicide patients treated in the Emergency Room were hospitalized, 63,15% of them with history of psychotic symptoms. 8,33% consumed alcohol or cocaine before the suicide attempt.

The parasuicide attempts are more frequent in young women. Suicide attempt is nearly twice more frequent in women than men. The most important variable to decide admission in a psychiatric ward was found to be a previous history of psychosis.

Despite the evident progress of medicine and psychiatry in recent decades there is an increase in the number of suicide attempts in psychiatric patients in outpatient and hospital settings.

To determine the epidemiological characteristics of suicidal patients admitted at the Psychiatric Clinic of the University Clinical Hospital Mostar.

We conducted a retrospective study in which we analyzed data from the medical history of 189 patients hospitalized after a suicide attempt at the Psychiatric Clinic of the University Clinical Hospital Mostar in the period from 2004 to 2013.

Patients who attempted suicide were more often females (52.9%), unemployed (47.6%), with lower (31.7%) and intermediate level of education (52.4%), married (45.5%), without children (37.6%) and were more likely to come from urban areas (75.7%). Most of the subjects had already been in some kind of psychiatric treatment (65.1%) before. The most common method of attempting suicide was poisoning (54.0%) and when observed by gender it was significantly more frequent in females (p<0.001). Male subjects were significantly more frequently alcohol (p=0.001) and drug (p=0.001) abusers, and also more frequently were participants in the last Civil war (p<0.001) and wounded during it (p<0.001).

Suicide attempts are more common in unemployed subjects, subjects with intermediate level of education, subjects who come from urban areas and in subjects who had previously received psychiatric treatment. The most common way of suicide attempts is by poisoning which was statistically significant in female subjects.