Directed by: Jonathan Dayton Starring: Greg Kinnear, Steve Carell, Toni Collette, Paul Dano, Abigail Breslin, Alan Arkin Year: 2006 Running time: 101 minutes
Plot: The story is about the trip of the Hoover family to take their 8-year old daughter Olive to the “Little Miss Sunshine” beauty pageant. Olive’s uncle Frank, a scholar of Proust, is temporarily living at home with the family after having attempted suicide. During the road trip, the family suffers numerous personal setbacks and discovers their need for each other’s support. The movie deals with very sensitive issues (homosexuality, fat and skinny shaming, suicide) seen through Olive’s eyes: travelling and overcoming difficulties together, the family becomes more united and resilient.
“Life is one fu***ng beauty contest after another. School, then college, then work […]
If I want to fly, I’ll find a way to fly.
You do what you love, and f**k the rest.”
Our Section member Federico M. Daray shared with us some recent papers published with his research group in Argentina:
How lipids may affect risk for suicidal behavior (Journal of Psychiatric Research, 104, 2018)
Suicidal ideation is associated with cardiovascular disease in a large, urban cohort of adults in the Southern Cone of Latin America (General Hospital Psychiatry, 57, 2019)
Serotonin transporter gene polymorphism as a predictor of short-term risk of suicide reattempts (European Psychiatry, 54, 2018)
Factors associated with postpartum depression in women from low socioeconomic level in Argentina: A hierarchical model approach (Journal of Affective Disorders 227, 2017)
Lethality of Previous Suicidal Behavior among Patients Hospitalized for Suicide Risk Predicts Lethality of Future Suicide Attempts (Suicide and Life-Threatening Behavior, 2018)
Suicide and suicidal behaviors can be influenced, among the others, by individual risk factors. The role of diet and metabolism is still poorly understood. Daray and coworkers describe in their work a theoretical model linking cholesterol and poly-unsaturated fatty acids (PUFA) status to 5-HT neurotrasmission and suicide risk. They also studied the relationships between cardiovascular disease (CVD) and suicidal risk in Southern Cone of Latin America: “There is a significant association between suicidal ideation and CVD, particularly among women, which may be driven, at least in part, by depression and physical functional impairment”.
In the literature there are many other works about metabolic syndrome, its correlates and suicide: for example, in 2013 Chang and coworkers (LINK) published the article “Metabolic Syndrome and the Risk of Suicide: A Community-Based Integrated Screening Samples Cohort Study” reporting that “Metabolic Syndrome was associated with an increased risk of suicide risk by 16% per MetS component, adjusting for demographics, life-style factors, and clinical correlates. Of the metabolic syndrome components, elevated blood pressure was independently associated with suicide-related mortality” (10-year follow-up period, 76.297 people recruited, 12.094 with Metabolic Syndrome, 146 death for suicide).
Maslov and coworkers (2009) (LINK ) investigated these factors in patients affected by Post-Traumatic Stress Disorder and Schizophrenia while D’Ambrosio et al. (2012) (LINK) in patients with bipolar disorder. It is widely acknowledged that these patients have higher rates of substances abuse, smoking, obesity, diabetes and cardiovascular disease (metabolic syndrome) and are at-risk for suicide, so the possible correlation among these variables was investigated.
Public mental health interventions targeting also these individuals factors may be warranted.
On the web you can find many articles, blogs about suicide among doctors.
There are also many related initiatives which have been implemented: for example June 1st is the #CrazySocks4Docs Day, an initiative started by an Australian physician in 2017 (a cardiologist who suffered from severe depression). The initiative now involves doctors in Canada, the UK, the US, New Zealand, Spain, France, and Ireland. It is not only for doctors but also for nurses, paramedics, medical students, veterinarians and all other specialties that work in the health care field: this is a way in which it is possible to talk about the health of the Health Care Professionals, fighting the stigma.
On March 2019, Lancet Psychiatry published the following article: “Interventions to reduce symptoms of common mental disorders and suicidal ideation in physicians: a systematic review and meta-analysis” (Petrie, K). It deals with a current topic, which is the increased prevalence of common mental disorders (depression, anxiety) and suicide among physicians. The authors identified 2992 articles, of which 8 were included in the systematic review and 7 in the meta-analysis. The results suggest that “physician-directed interventions are associated with small reductions in symptoms of common mental health disorders among physicians” and that “modification of the work environment is urgently needed”.
We proposed the topic of physician and mental health in other reading suggestions in the past year. In September on Jama Psychiatry it was published the article “A Physician’s Suffering – Facing Depression as a Trainee”, which focused on the impact that a physician suicide may have on colleagues; in May 2018 on BMJ it was published the free meta-analysis and systematic review “Psychosocial job stressors and suicidality: a meta-analysis and systematic review”.
As stressed in our previous suggestions, the medical profession is one of the occupations with the highest risk of death by suicide (one physician is estimated to die by suicide each day in the USA) and this is often an “uncomfortable” topic for discussion.
Also our Secretary C. Gramaglia and our member P. Zeppegno published on April 2018 an Opinion on Frontiers in Psychology, edited by our Co-Chair J. L. Castroman titled “Medical Students and Suicide Prevention: Training, Education, and Personal Risks”. The article stresses the importance of a specific training focusing on the risk of depression and suicide risk among medical students and practitioners. The article is open access HERE.
See our previous reading suggestions to know more:
Plot: This movie by Bergman is about a psychiatrist, who is suffering from a mental illness. Dr. Jenny Isaksson is a psychiatrist, married to Erik, who is a psychiatrist as well. Jenny is haunted by images and emotions from her past, which interfere with her everyday life and duties; she goes through a mental breakdown and tries to commit suicide.
“We are not afraid of the horrors we know. They are the ones we don’t know who frighten us”.
Plot: It is an American drama film Based on Jodi Picoult’s 2004 novel. The story is about Kate, who had acute promyelocytic leukemia, and her younger sister Anna, conceived by in vitro fertilization, genetically matched to her sister to donate compatible organs, blood, and tissue to help her. When Anna grows up, she tells her parents that she does not want to be a donor anymore, trying to obtain through a process the medical emancipation, even if she knows that her sister will finally die because of her decision. She starts a fight against her mom Sara, who wants to keep Kate alive. When Kate attempts suicide by a painkillers overdose, Anna stops her. The movie well explains Kate’s desire not to live any longer, asking her sister to refuse to donate her blood and organs, and to let her die.
A previous movie suggestion has been “The Sea Inside” (LINK), in line with the current debate concerning euthanasia and assisted suicide: “The topic is the object of current debates involving the whole clinical community, and it has also been the focus of two intersection symposia organized by the EPA-SSSP together with the Old Age Psychiatry Section in 2017 in Florence, and in 2018 in Nice” (LINK).
“There are some things we do because we convince ourselves it would be better for everyone involved. We tell ourselves that it’s the right thing to do, the altruistic thing to do. It’s far easier than telling ourselves the truth.” Jodi Picoult, My Sister’s Keeper
On 1st January 2019 on JAMA Psychiatry it was published the article “Risk of Suicide After Cancer Diagnosis in England”. In the literature it is widely acknowledged that a diagnosis of cancer maybe a risk factor for psychological distress, depression, anxiety and suicide: there are many resources that may be used in order to prevent these events, and all clinicians (not only psychiatrists) should quantify the risk of any patients using prevention strategies. In the study published on JAMA, of the 4 722 099 cancer patients enrolled, 2491 patients died by suicide, representing 0.08% of all deaths during the follow-up period.
The article “Incidence of Suicide in Persons With Cancer” published on the Journal of Clinical Oncology in 2008 reported that the incidence of suicide in patients with cancer was approximately twice that of the general US population.
Both articles found that suicide risk was different for different types of cancer (highest among patients with mesothelioma, pancreatic, esophageal, lung and stomach cancer) and that it was highest in the first 6 months following cancer diagnosis. Perhaps, lower quality of life in patients with some kind of cancer may be related to emotional distress; others could have a devastating effect on quality of life through their impact on physical appearance and essential functions such as speech, swallowing, and breathing.
Researchers stress that suicide in cancer patients can be considered as a potentially preventable death cause, and that patients may need psychological support during the first 6 months after cancer diagnosis.
Last, cancer diagnosis potentially involves end-of-life decisions; there are different studies about this topic; for example, the article “End-of-life decision-making across cancer types: results from a nationwide retrospective survey among treating physicians”, published on the British Journal of Cancer in 2018. This study was about a large random sample of all deaths in Flanders and Belgium in which all cancer deaths were selected (n = 2392): euthanasia or physician-assisted suicide were chosen in 8.7-12.6% of the cases, independent of cancer types.
Directed by: Frank Capra
Starring: James Stewart, Donna Reed, Lionel Barrymore
Running time: 131 minutes
The film is considered one of the most loved films in American cinema, and has become traditional viewing during the Christmas season.
Plot: it’s an American Christmasfantasy comedy-drama film, based on the short story and booklet The Greatest Gift (Philip Van Doren Stern, 1939). The story is about George Bailey who is thinking about suicide on Christmas Eve (1945); in Heaven, Clarence, is assigned to become George’s guardian angel. Clarence shows George all the lives he has touched, and how different life in his community of Bedford Falls would be if he had never been born, offering him the greatest Christmas gift.
The story reminds us about Mozart’s Papageno. In Singspiel, Papageno tries to attempt suicide, but he is saved by the three child-spirits: they remind him the magic power of the bells he was gifted at the start of the story (Click HEREto know more about Papageno). In suicide prevention the Papageno effect is the positive role that media can play in order to prevent suicide, in contrast with the Werther effect. Recently, many media recommendations have been implemented worldwide to foster suicide prevention and improve the quality of media reporting about suicide. Movies, TV-series, newspapers, websites and other media resources may help vulnerable people to find positive qualities, coping strategies to face off difficult moments and, as is suggested in the literature, this effect is most pronounced in an audience with increased vulnerability to suicide.
“Media can make a very relevant contribution to suicide prevention by minimising sensationalist reporting, and maximising reporting on how to cope with suicidality and adverse circumstances”.
Does psychopathology vary due to the influence of Christmas holidays? Since we are approaching Christmas and the arrival of the new year, the question is timely. We found an article published on Innovations in Clinical Neuroscience in 2011, “The Christmas Effect on Psychopathology” (Sansone et al), which offers an overview of the literature about this topic. The article reports about different issues in the field of mental health, such as access to emergency room services on behalf of psychiatric patients, depressive symptoms, substance abuse and also self-harm behaviors, suicide attempts and suicide. The Authors report that according to the literature, deliberate self-harm decreases around Christmas holidays, in particular in younger patients; suicide attempts rate decreases during Christmas period, but some studies reports that it may increases during the New Year holiday.
On Psychology Today, it is suggested a correlation between the reduction of these events and a protective effect exerted by the proximity of relatives and the hope of ‘things getting better from here’.
A previous reading suggestion (#17, March 2018) was about a recent publication by our member Christina Van der Feltz-Cornelis on Frontiers in Psychiatry, “Springtime Peaks and Christmas Troughs: A National Longitudinal Population-Based Study into Suicide Incidence Time Trends in the Netherlands” in which it is stressed that suicide incidence was 42% lower at Christmas, compared to the December-average (IRR = 0.580, p < 0.001), but after Christmas, a substantial increase occurred on January 1, which remained high during the first weeks of the new year.
Directed by: Tom Hopper
Starring: Hugh Jackamn, Russell Crowe, Anne Hathaway, Amanda Seyfried, Eddie Redmayne, Helena Bonham Carter
Running time: 158 minutes Among the others awards, Anne Hathaway won the “Academy Award for Best Supporting Actress” (Oscar 2013).
Plot: Les Misérables (2012) is a musical drama film, based on the French novel by Victor Hugo. Events take place in France during the early 19th century and the movie describes the stories of many characters, representing different social layers. The main characters are: Jean Valjean, released after 19 years of imprisonment for stealing bread; Javert, a police agent who dedicates his life to imprisoning Valjean once again; Fantine, a factory worker forced to prostitute herself after losing her job to support her daughter Cosette; Marius, a revolutionary student. In the movie these stories intertwine each other.
We chose this movie because we wanted to focus on two characters: Javert and Fantine.
Javert spends all his life trying to catch Jean Valjean and send him back to prison; he becomes slave of this condition and when he realizes Valjean is not only a thief but is also capable of pity (“Is he from heaven or from hell?”), understanding that he may have been wrong, he can not find a reason to live anymore.
Fantine fell in love with Tholomyes and from this relationship a children was born, Cosette; Tholomyes abandoned them so Fantine is forced to work to sustain Cosette. She is teased by her co-workers when they discover that she is a single mother and her foreman makes sexual provocations to her. The coworkers ask to fire her because they don’t want problems (“you must send the slut away, or we’re all gonna end in the gutter”) and the foreman, hurted from the secret, asks her to go on her way. The poor woman is therefore forced to prostitute herself and is mistreated and derided by men who abuse her for little money. She then no longer ate and drank anything but brandy to keep warm and not to think about his condition.
Fantine is the literary and cinematographic example of the abused women, deluded and then disappointed from men but also from other women, victim of the prejudice. Anne Hathaway, who played Fantine’s role and won the Oscar for it, said about the character: “I searched Fantine in a dark place in my heart. On the set I felt a great anger for what is done to her, the generous heart transformed into pure hatred in order to survive.(…) For a woman the condition was difficult even fifty years ago. I have also researched the present, there are many women in the world who sell their bodies to keep their children. It seems to me that this is the right historical moment to make the human condition really better“.
This is the reasons why we chose this character for the International Day for the Elimination of Violence against Women.
“There was a time when men were kind When their voices were soft And their words inviting There was a time when love was blind (…) Then it all went wrong I dreamed a dream in times gone by (…) I dreamed, that love would never die (…) But the tigers come at night With their voices soft as thunder As they tear your hope apart As they turn your dream to shame”