Frequency of suicide on Gotland after systematic postgraduate education of general practitioners

Acta Psychiatrica ScandinavicaPublished 1 August 1989

Wolfgang Rutz, Lars von Knorring, Jan Wålinder

DOI10.1111/j.1600-0447.1989.tb01318.x

Source URL

Citations311

SJR quartileQ1

SJR score2.51

SNIP2.00

TL;DR

Programs aiming at giving GPs increased capacity and responsibility to treat patients with affective disorders do not increase the frequency of suicide and better primary treatment of patients with depressive disorders may reduce the suicide rate in a given area.

Abstract

In 1983-1984 the Swedish Committee for Prevention and Treatment of Depression (PTD Committee) introduced an educational program for all general practitioners (GPs) on the Swedish island of Gotland. The primary goal was to increase knowledge about diagnosis and treatment of patients with affective disorders. The effects of the educational programs were evaluated in detail; GPs identified more patients with depressive disorders and treated them more accurately. The suicide rate on Gotland was followed, primarily to ensure that the new treatment strategies did not include a risk for the individual patients. However, it was also hoped that increased awareness of patients with affective disorders and better treatment routines could reduce the suicide rate. The suicide rate dropped the year after the educational programs were introduced. This was a statistically significant deviation both from the long-term trend on Gotland and from the trends in Sweden as a whole. Programs aiming at giving GPs increased capacity and responsibility to treat patients with affective disorders do not increase the frequency of suicide. Better primary treatment of patients with depressive disorders may reduce the suicide rate in a given area.

Keywords

Health Professions

Archives of General PsychiatryMortality in Depressed Patients Treated With Electroconvulsive Therapy and Antidepressants

350 Citations1976David Avery

The electroconvulsive therapy group had a significantly lower mortality than the inadequate antidepressant treatment group and the group that received neither ECT nor antidepressants, which underscores the importance of adequate treatment of depression, especially in the older man.

Archives of General PsychiatrySuicide, Attempted Suicide, and Relapse Rates in Depression

155 Citations1978David Avery

A depressive diagnosis may be as good a predictor of suicidal behavior as a history of attempted suicide, and relapse rates did not differ between treatment groups.

Acta Psychiatrica ScandinavicaAn educational program on depressive disorders for general practitioners on Gotland: background and evaluation

144 Citations1989Wolfgang Rutz, Jan Wålinder +6 more

The PPD program was associated with decreases in the use of psychiatric inpatient care and the sick leave frequency of depressed patients, and the possibility of preventing suicides was positively influenced.

Psychological MedicineHave the Samaritans lowered the suicide rate? A controlled study

70 Citations1978Chris Jennings, B. M. Barraclough +1 more

The scientific case for the effectiveness of the Samaritans in reducing the suicide rate is seriously weakened because of no statistically significant differences between Samaritan and control towns.

Archiv für Psychiatrie und NervenkrankheitenSuicide in Norwegian, Finnish, and Swedish psychiatric hospitals

59 Citations1977R Hessø

The suicide rate in the psychiatric hospitals of all three countries has risen markedly and may be regarded as a side-effect of modern therapeutic methods, with the introduction of the open-door policy, milieu therapy, ataractic drugs, rehabilitation pressure, and democracy processes.

PubMed[Suicides during treatment in a psychiatric hospital (author's transl)].

19 Citations1982José Fernando Schlosser, G Strehle-Jung

It is found that there was an increase in the suicidal rate following a change in the organisational and therapeutical skeleton concept of the clinic, but the question whether there is a causal relationship must remain unsettled.

Nordisk Psykiatrisk TidsskriftEvaluation of postgraduate medical education given by the Swedish PTD Committee

14 Citations1986Göran Eberhard, Gunnar Holmberg +6 more

The Swedish Committee for the Prevention and Treatment of Depression (the Swedish PTD committee) has created a series of educational programmes to be used in post-graduate education of general practitioners; they deal with the etiology, pathogenesis, diagnosis and treatment of depression.

European Archives of Psychiatry and Clinical NeuroscienceAssociation between changes in psychiatric services and increases in suicide rates

9 Citations1982Ó. Bjarnason

It is concluded that the changes in the psychiatric services are associated with an increase in the rate of suicide and that this increase may to some extent be a side effect of therapeutic methods introduced after 1965.

Nordisk Psykiatrisk TidsskriftSuicidutvecklingen Och Dess Bakgrundsfaktorer I En Allt öppnare Psykiatrisk Slutenvård: Exempel Gotland

4 Citations1981Wolfgang Rutz