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      A scoping review of community pharmacists and patients at risk of suicide

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          Abstract

          <div class="section"> <a class="named-anchor" id="section1-1715163517733482"> <!-- named anchor --> </a> <h5 class="section-title" id="d2840290e155">Background:</h5> <p id="d2840290e157">Medications are commonly used in suicide attempts. Pharmacists are inextricably linked to medications and may have roles in helping those at risk of suicide. We conducted a scoping review to characterize the existing literature and make recommendations about future research. </p> </div><div class="section"> <a class="named-anchor" id="section2-1715163517733482"> <!-- named anchor --> </a> <h5 class="section-title" id="d2840290e160">Methods:</h5> <p id="d2840290e162">We used a 6-step approach based on an existing scoping review methodological framework, including identifying the research question; identifying relevant studies and other literature; study and literature selection; data charting; collating, summarizing and reporting results; and dissemination of results. We searched electronic databases, various grey literature sources and mobile app stores. </p> </div><div class="section"> <a class="named-anchor" id="section3-1715163517733482"> <!-- named anchor --> </a> <h5 class="section-title" id="d2840290e165">Results:</h5> <p id="d2840290e167">Thirty-five articles were included following screening of 1013 database citations. Of 1085 results from grey literature searches, we included 12. Most publications were opinion pieces ( <i>n</i> = 22), followed by survey studies ( <i>n</i> = 9), primarily assessing pharmacists’ knowledge and attitudes. Themes included education and training to impact knowledge and attitudes, gatekeeping of medication supply, collaboration and integration, and role perception. Public perspectives on pharmacists’ roles were limited. </p> </div><div class="section"> <a class="named-anchor" id="section4-1715163517733482"> <!-- named anchor --> </a> <h5 class="section-title" id="d2840290e176">Conclusions:</h5> <p id="d2840290e178">Research regarding pharmacists’ roles in the care of people at risk for suicide is limited. The areas that have dominated the literature include legal liability, especially with respect to gatekeeping medications, ethical decision making and education and training. Research is needed to determine what methods, outcomes and measures are required to best serve in building the evidence base for policy and practice decisions in this area. </p> </div>

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          Most cited references37

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          Health care contacts in the year before suicide death.

          Suicide prevention is a public health priority, but no data on the health care individuals receive prior to death are available from large representative United States population samples.
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            Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey.

            The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community. The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys. Suicide attempts (0.4-4.2%), plans (1.1-15.6%), and ideation (2.6-25.4%) varied by a factor of 10-14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts. The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.
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              A meta-analysis of cognitive functions in children and adolescents with major depressive disorder.

              The cumulative prevalence rates of major depressive disorders (MDD) in children and adolescents averages 9.5 %. The majority of adults with MDD suffer from significant cognitive deficits, but the available neuropsychological data on the cognitive performance of children and adolescents with MDD yielded mixed results. Meta-analytic methods were used to assess the severity of cognitive deficits in children and adolescents with MDD as compared to healthy children and adolescents. We identified 17 studies comparing the intelligence, executive functions, verbal memory and attention of 447 patients with DSM-IV MDD and 1,347 healthy children and adolescents. Children and adolescents with MDD performed 0.194-0.772 (p < 0.001) standard mean differences worse than healthy control subjects in neuropsychological test procedures. The most pronounced deficits of children and adolescents with MDD were seen in inhibition capacity (STD = 0.772; p = 0.002), phonemic verbal fluency (STD = 0.756; p = 0.0001), sustained attention (STD = 0.522; p = 0.000), verbal memory (STD = 0.516; p = 0.0009) and planning (STD = 0.513; p = 0.014). We revealed cognitive deficits of children and adolescents with MDD in various cognitive domains. Long-term studies should investigate how the cognitive deficits of depressed youth affect their academic and social functioning, and whether age, comorbidity and depression severity play a role in this process.
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                Author and article information

                Journal
                Canadian Pharmacists Journal / Revue des Pharmaciens du Canada
                Can Pharm J
                SAGE Publications
                1715-1635
                1913-701X
                October 24 2017
                November 2017
                October 05 2017
                November 2017
                : 150
                : 6
                : 366-379
                Affiliations
                [1 ]College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
                [2 ]Department of Psychiatry (Gardner), University of Sydney, Sydney, New South Wales, Australia
                [3 ]Dalhousie University, Halifax, Nova Scotia, and the Faculty of Pharmacy (O’Reilly), University of Sydney, Sydney, New South Wales, Australia
                Article
                10.1177/1715163517733482
                5661676
                29123596
                b986b261-aee0-4529-8d6e-15a9246d986d
                © 2017

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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