The prevention of suicide among older people in The Netherlands: interventions in community mental health care.

About one third of all suicides in the Netherlands are committed by elderly people. Yet, until recently no discernible initiatives have been taken to prevent suicide among the elderly. One of the possibilities that has not yet been considered is the use of mass media. In this article some thoughts are presented on the use of television and other media for communicating messages designed to identify depressive symptoms and to counter suicidal tendencies by mobilizing relatives and friends. Epidemiological findings on suicide among elderly persons in the Netherlands are presented, along with data on the role of the general practitioner and the mental health care system in suicide prevention. It is stressed that because of a number of unfortunate circumstances many depressed elderly people do not receive adequate treatment: Because they survived many major life events, their relatives wrongly consider them to be strong enough to cope with yet another major life event, loss or threatening condition. Relatives may think of depressed symptoms as a natural reaction, and may not consider these to be alarming. If they are alarmed, relatives may not know that depression is a treatable condition, or where they may be able to seek psychological assistance. Depressed elderly people might not be willing to share depressed feelings or thoughts concerning death and dying, or admit having suicidal ideation. Symptoms of depression may be confused with the normal aging process, both by the person him- or herself and by his or her relatives and friends.

[Osteolytic forms of rheumatoid polyarthritis. Personal cases and review of the literature]. / Formes ostéolytiques de la polyarthrite rhumatoïde. Observations personnelles et revue de la littérature.

The authors report eight personal cases of severe and multiple osteolysis in rheumatoid arthritis. 42 other cases were found in the international literature. Osteolytic rheumatoid arthritis concern almost exclusively women, often with small stature. Lesions prevail on upper limbs. All peripheric joints can be involved, except knees, ankles and tarses. The most typical and the most constant aspect is the "opera glass hands". Extra-articular manifestations occur in the same rate as for common rheumatoid arthritis. Rheumatoid factor are present in 2/3 of the cases. Pathogeny of these osteolyses remains unknown and a neurologic mecanism is inprobable.