Marte Meo Counselling given to African caregivers of institutionalised infants a three-case study.

BACKGROUND: Studies from Western countries state that video interaction guidance programmes can support caregiver sensitivity in infant-caregiver dyads. OBJECTIVES: The aim of this study was to investigate if Marte Meo, which is such a programme, could contribute to increasing emotional and social support towards motherless infants at an institution for motherless infants in rural Africa. METHOD: Three caregivers participated in five Marte Meo Counselling sessions. The first guidance naïve film and the last film were analysed qualitatively and quantitatively and organised according to two supportive categories: 1) caregiver responds to infants' initiative, 2) caregiver takes initiative to supportive interaction, and two non-supportive: 3) caregiver behaves in an intrusive manner and 4) caregiver does not respond to the infants' initiative. RESULTS: After receiving Marte Meo Counselling, all three caregivers showed impressive augmentation of awareness and sensitivity in their care towards the infants' emotional and social needs. CONCLUSION: We found indications that professional caregivers of institutionalised infants in an African country can profit on Marte Meo Counselling, showing positive effects on augmenting caregivers' sensitivity towards the infants, and thereby meet the infants' need of emotional and social support.

Acute poisoning among children and adolescents in southern Norway. / Akutt forgiftning blant barn og ungdom i Agder.

BACKGROUND: Self-inflicted poisoning is common in adolescents and is a risk factor for suicide. The aim of this study was to survey the circumstances surrounding hospitalisations due to acute poisoning in patients aged up to 18 years. MATERIAL AND METHOD: All hospitalisations in the Departments of Paediatric and Adolescent Medicine, Sørlandet Hospital Trust (Arendal and Kristiansand) due to acute poisoning in the period 1 August 2014-31 July 2015 were prospectively recorded with the aid of a form completed during the admission. RESULTS: There were 88 hospitalisations distributed among 68 adolescents (mean age 15.5 years, SD 1.5) and 13 children (mean age 2.8 years, SD 2.8). The poisoning was categorised as self-harm behaviour in 32 (47 %) of the adolescents, and as substance misuse-related in 35 (52 %). In total, 37 (54 %) of the adolescents had been or were under treatment at the Department of Child and Adolescent Psychiatry. Fifteen (22 %) of the adolescents were deemed to be suicidal. Thirty (94 %) of the adolescents who reported self-harm as the intention behind their poisoning were offered further follow-up at the Department of Child and Adolescent Psychiatry, along with 7 (20 %) of the group with substance misuse-related poisoning. INTERPRETATION: Adolescents who reported self-harm as their intention were usually offered further follow-up, whereas adolescents with substance misuse-related poisoning were rarely offered follow-up.

Suicides, mental health care and interdisciplinary specialised addiction services in the Agder counties 2004-13. / Selvmord, psykisk helsevern og tverrfaglig spesialisert rusbehandling i Agder 2004 ­ 13.

BACKGROUND: Most of those who commit suicide suffer from one or more mental disorders. We wished to identify the proportion that had been in contact with mental health care or interdisciplinary specialised addiction services during their lifetime and in the year prior to their death, and to describe characteristics of these patients. MATERIAL AND METHOD: Information on suicides in the Agder counties in the years 2004­2013 was retrieved from the Cause of Death Registry. Patient records from Sørlandet Hospital were reviewed with the aid of a structured form. RESULTS: Altogether 329 suicides were included in the study. Of these, 66.6 % had at some point in life been in contact with mental health care or interdisciplinary specialised addiction services, 46.2 % during the year preceding their suicide. Altogether 28.6 % were actively undergoing treatment. The proportion who had been in contact in the preceding year tended to be lower among patients younger than 20 when compared to other age groups. Among those who had completed their treatment, there were more patients with adaptation disorder than in the group that remained in treatment; among those who remained in treatment there were more patients with psychotic disorders than among those who had completed their treatment. INTERPRETATION: A higher proportion of those who committed suicide in the Agder counties were in contact with mental health care and interdisciplinary specialised addiction services than what has been found in equivalent international studies. The findings underscore the need to develop effective measures to prevent suicides in these groups of patients.

Characteristics of suicide notes of children and young adolescents: an examination of the notes from suicide victims 15 years and younger.

OBJECTIVE: By analysing the suicide notes from suicide victims 15 years and younger, we attempt to gain insight into the process leading to youth suicide and explore the characteristics of the note writers. METHOD: During a psychological autopsy on 42 youths, we were entrusted with 23 suicide notes in which we explored the themes and compared the note writers to the non-note writers. RESULTS: The key messages were as follows: explain the reason for suicide, declare love and give instructions. The note writers had showed suicidal behaviour more frequently than non-note writers. CONCLUSION: In the notes from youth suicide victims they present themselves as fully responsible and without confusion or overwhelming despair. The notes are likely equally informative as the notes of older victims.

Suicide or accident? A psychological autopsy study of suicide in youths under the age of 16 compared to deaths labeled as accidents.

OBJECTIVE: In the present paper, we describe suicide in youths under 16 years of age and compare their risk factors for suicide to those of older adolescents as described in the literature. Furthermore, we evaluate the possible mislabeling of suicides as accidents, and vice versa. METHOD: We used the data from a nationwide psychological autopsy of youths 15 years and younger who had committed suicide or died in accidents in Norway from 1993 to 2004 (n = 84). We additionally constructed a suicide index to distinguish between the two causes of death. RESULTS: The young suicide victims presented, with little gender difference, fewer obvious risk factors and less suicide intent than commonly described for older adolescents. The suicide index distinguished quite well between suicides and accidents, with few cases indicating a possible mislabeling, although some suicide cases could have been labeled as uncertain. CONCLUSION: In line with previous research, suicides in 11-15-year-olds have many similarities to suicides in older adolescents in terms of external circumstances, but they present less apparent warning signs. In our total sample of 84 deaths, there were few indications of incorrect labeling.

Differences between children and adolescents who commit suicide and their peers: A psychological autopsy of suicide victims compared to accident victims and a community sample.

BACKGROUND: The purpose of this study was to gain knowledge about the circumstances related to suicide among children and adolescents 15 years and younger. METHODS: We conducted a psychological autopsy, collecting information from parents, hospital records and police reports on persons below the age of 16 who had committed suicide in Norway during a 12-year period (1993-2004) (n = 41). Those who committed suicide were compared with children and adolescents who were killed in accidents during the same time period (n = 43) and with a community sample. RESULTS: Among the suicides 25% met the criteria for a psychiatric diagnosis and 30% had depressive symptoms at the time of death. Furthermore, 60% of the parents of the suicide victims reported the child experienced some kind of stressful conflict prior to death, whereas only 12% of the parents of the accident victims reported such conflicts. CONCLUSION: One in four suicide victims fulfilled the criteria for a psychiatric diagnosis. The level of sub-threshold depression and of stressful conflict experienced by youths who committed suicide did not appear to differ substantially from that of their peers, and therefore did not raise sufficient concern for referral to professional help.