Reviews of Suicidality: A Roadmap for Assessment and Treatment

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Click here to purchase the eBook Suicidality: A Roadmap for Assessment and Treatment.


“This pioneering work by Sheehan and Giddens will challenge your preconceptions about suicide! Based on careful, detailed in-depth observations, they provide extraordinarily insightful descriptions and understandings of the daily experiences of suicidal patients. These observations are the platform upon which they propose an innovative and logical reconceptualization of the field of suicidality. They propose clinically informed, yet innovative heuristic models (at both the clinical descriptive and cellular levels) that can evolve as further evidence is accrued. The book also provides a raft of clinically useful tools to help assess, diagnose and manage patients struggling with suicidality. This book is filled with clinical insights that are the foundation for revising how we think about, understand, manage and measure suicidality in practice and research. This book is a “Must Read” for clinicians, educators or researchers that will change research and practice. Prepare to rethink! It will be worth it! This book will revitalize the field of suicidology.” – John Rush, MD; Professor Emeritus, Duke-National University of Singapore; Deputy Editor, American Journal of Psychiatry


“There are now about 40,000 deaths annually in the United States due to suicide. “Suicidality: A Roadmap for Assessment and Treatment” is an important addition to the literature to help clinicians classify patients with suicidal behaviors and hopefully to prevent their suicide. I particularly liked the hyperlinks, which enable the reader to access references.  The inclusion of suicidality scales and structured diagnostic assessments is also unique to this volume. I recommend this important book to any clinician who deals with patients with the potential for suicide.” – David L. Dunner, MD, FACPsych; Director, Center for Anxiety and Depression; Professor Emeritus, Department of Psychiatry and Behavioral Sciences, University of Washington


“Suicidality: A Roadmap for Assessment and Treatment is enormously informative about the assessment and treatment of suicidality. It offers a wealth of new ideas and aproaches that could greatly advance the field. It will also foster much needed research into hitherto neglected areas of study. Some of the findings may well be lifesaving.” – Michael Liebowitz, M.D.; Professor of Clinical Psychiatry; Columbia University


“Suicidality by Sheehan and Giddens is a landmark contribution to the field.  It provides much needed clarifying definitions as well as pragmatic methods for assessing suicidality in clinical settings that significantly advance the state of the art.  Encyclopedic, this book is novel, comprehensive and at times provocative and sure to become the standard text on this important dimension of psychiatry.” – Stephen M. Stahl, MD, PhD; Adjunct Professor of Psychiatry; University of California San Diego; Chairman, Neuroscience Education Institute


“Professor David Sheehan has prepared a brilliant, scholarly summary of the never-ending rapidly evolving state of the art in the recognition, treatment, and prevention of suicide and suicide behaviors. He has prepared an authoritative treatise that has both scholarly appeal as well as clinically relevant pragmatic appeal. The field owes the Professor a debt of gratitude for his several decade commitment to this very challenging scientific focus, as well as his authoritative, concise and efficient summary of the most current and clinically meaningful data focusing on this very important source of worldwide premature death. Our thanks to the Professor for his roadmap and his lifelong commitment to this area of unmet need.” – Joseph R. Calabrese, MD; Bipolar Disorders Research Chair; Case Western Reserve School of Medicine; Director, Mood Disorders Program; University Hospitals Case Medical Center; Professor of Psychiatry; Case Western Reserve University School of Medicine


“This book is brilliant! It is a masterpiece which will, no doubt, be recognized in the next coming years as the book (the bible) to be read to understand suicidality. The book has 13 chapters and two appendices including scales and related documents. I liked chapter 1 very much for its thought-provoking angles with a list of questions about willfulness, causes, phenomena (e.g., terms to be used: “suicidal ideation or behavior” vs. “suicidality”), the need for a classification, and the predictability of the phenomena. Chapter 2 offers an innovative model to understand suicidality: the authors propose a non-linear, dynamic model inspired from the work of Edward Lorenz, Henri Poincaré, or Robert Stetson Shaw. The pattern presented in this section displays episodic turbulence / chaos / unpredictability. In other words, it is consistent with chaos science. The graphic presentations are also particularly enlightening. I particularly enjoyed the section where the authors explain how this model may benefit clinicians and researchers. I will let you find out what the model suggests! Finally, you will understand the graphic on the front cover of the book better after you read this chapter. Moving on, the authors propose, in a thorough and comprehensive way, definitions and classifications for the phenomena (Chapter 4), events (Chapter 5) and disorders (Chapter 6). Chapter 9 provides an insight about the treatments that could be used to treat suicidality. I was struck by the close proximity in the Mendeleyev Table (in groups 1 and 2) of several treatments that have been used (such as Lithium, Magnesium and Calcium). Coincidence? Accidental relationship? Nature has its own mysteries. Chapter 10 is of prime interest for all researchers involved in assessing suicidality either in clinical practice or research settings. It is a mine of information! There are so many interesting parts to this book that I am unable to cover them all! To conclude, readers should dive into chapter 12.3 – a case study on a new anti-suicidality medication, which provides hope for the future. Thank you David and Jennifer for making history, considering the patient’s perspective, and providing guidance to clinicians. Merci !”Catherine Acquadro, MD; Scientific Advisor, Mapi Research Trust and Mapi, Lyon, France


A rare treat! This book is innovative, provocative, and filled with creative wisdom. It is full of truly groundbreaking research ideas and packed with practical insights and effective strategies for any clinician hoping to save a life. My advice is simple. Buy it. Read it. Apply its wisdom.” – Shawn Christopher Shea, M.D.; Director, Training Institute for Suicide Assessment and Clinical Interviewing (TISA); Author of “The Practical Art of Suicide Assessment”


A long awaited indispensable and user friendly book for the practicing clinicians, educators, and researchers alike. The contents are driven by a sensible recognition of the need for a structured scientific approach that both consider patient’s perspectives and maximize our efficacy to diagnose and treat Suicidality. Building on their distinguished clinical research experience and their extensive past efforts in developing structured diagnostic instruments and assessment scales, the authors undoubtedly opened up a new era whereby we would feel more equipped to better understand and manage our patients.  After decades of stagnation punctuated by moments of total loss in recent years, the field will finally be able to move forward guided by this landmark work.Ossama T. Osman, M.D., DABPN, FAPA; Associate Professor of Psychiatry; College of Medicine and Health Sciences; United Arab Emirates University


“The book is a masterpiece of scientific work that is making a start of suicidology; it is a roadmap, which will lead to the development in the field in the next few years as bit has established the ground for many research projects. The book has changed the way in which we should deal with psychiatric phenomenology, nosology, diagnosis and management; I hope researcher will consider using this methodology to develop psychiatry. Reading the book was of great benefit for my psychiatric practice.” – Dr. Walid Sarhan, F.R.C. Psych; ‪Consultant Psychiatrist; IDF of the American Psychiatric Association; The Chief Editor of the Arab Journal of Psychiatry; WPA Zonal Representative of the Middle East; www.walidsarhan.net


“In their roadmap on suicidality, Sheehan and Giddens have produced a masterpiece. This authoritative treasure trove is sure to become a respected and widely consulted document, as well as a rich source of testable hypotheses on the classification, assessment, treatment and pathology of suicidality. Suicidality reflects the collective experience of many decades on the part of the authors and their colleagues. Shining through conspicuously is the clinical skill, research experience and sharp observation of the authors, whose deep familiarity with the broad spectrum of suicidality is in evidence. Readers will appreciate the parsing of suicidality into several subtypes and the important message that not all suicidal behavior is the same: different treatment approaches are reasonably advocated for the various pathologies of suicidality. Some novel treatments are described, including the exciting use of magnesium, and the book provides a nuanced discussion on the pros and cons of other drug classes, in particular the perils and benefits of serotonergic antidepressants. One valuable feature of Suicidality is its inclusion of very precise directions on the application of medicines and psychotherapeutic techniques, as if the authors are there in office guiding the clinician along in how to administer a particular treatment.  Sheehan and Giddens’ Suicidality Roadmap can be recommended unequivocally for all those who wish to know more, or who are concerned about suicidality.” – Jonathan R. Davidson, MD; Professor of Psychiatry and Director of the Anxiety and Traumatic Stress Program; Duke University Medical Center


“This book of Sheehan and Giddens offer a broad look of the phenomena related to suicide (grouping it into the concept of suicidality) beyond mood disorders (and other disorders) or as a side effect of certain interventions, but as a phenomenon which requires to be grouped into syndromes with particular courses, which may be independent of other psychiatric comorbid conditions and can respond specifically to certain interventions.  As the title says, this book provides a roadmap to the development of a new nomenclature as well as a way to evaluate new treatments.  This “reductionistic” exercise gives several difficulties that could derail the attempt (as the inability to define valid syndromes, possible to be detected reliably and capable to be tracked), but this book delivers good reasons to consider that this task is affordable.  Why trust in Sheehan for this task? Not only for its extensive experience in the field of clinical trials or in the development of interviews and scales to capture and measure clinical phenomena, but also in his early experience in the description and development of panic disorder.  In this sense, Sheehan has traveled this road before: capture a previously diffuse condition to define a consistent phenomena and develop ways to detect effective treatments; along with Klein and several others took this set of symptoms now we known as panic, in a consistent (virtually unchanged so far), solid construct with specific and effective treatments. One can imagine that at that time some may have thought that try to reduce anxiety to a disorder or identify a biological marker (remember the lactate or hypercapnia challenges) was a reductionist exercise (proper of “biologicist” psychiatrists) but time gave the reason to Cohen, Klein, Sheehan and several others who contributed in that road.  This book is groundbreaking again in our field, and surely we will appreciate in years to come when we will have effectives pharmacological and psychotherapeutic interventions for the worst outcome in mental health.  We should thank Sheehan and Giddens for his enormous contribution to our discipline.” – Danilo Quiroz, MD; Profesor Adjunto, Facultad de Medicina Universidad Diego Portales; Director, Centro enfermedades del ánimo Efeso; Presidente fundador, Sociedad Chilena de Trastornos Bipolares; Editor, International Journal of Bipolar Disorders; www.practicapsiquiatrica.com


“We are entering a new era in the understanding, classification, measurement and treatment of suicidality. This is a must read for everyone in the helping professions and will exceed your expectations with its innovative sections on neurobiology, genetics, pharmacology and classification. It succeeds at everything you would like – being informative, practical, clear and comprehensive.”Daniel D. Christensen, MD; Clinical Professor of Psychiatry, Clinical Professor of Neurology, Adjunct Professor of Pharmacology, University of Utah


“After reading this book about newly discovered, evidence-based information on suicide, I realized that our standard of medical practice is, in many ways, not much better than a Magic 8-BallTM method of assessing suicide risk. As a private psychiatrist and a consultant reviewer of complaints for a state licensure board, I predict that these clinical discoveries will result in a new standard of medical practice. When I was a medical student, the eminent neurologist, David B. Clark, M.D., took me aside into an empty exam room and told me, “If you will just listen to your patients, they will tell you what is wrong with them.” David V. Sheehan, M.D., already a distinguished and experienced professor of psychiatric research, undertook studying suicide, starting from scratch by listening to persons with suicidality and thereby learning from them. From patients’ explanations, he mined precious ore of startling, previously unknown information, which he and Giddens rigorously refined and researched. They milled it into a form that frontline clinicians will find invaluable. This new suicidality information is helping clinicians like me to better save lives. I have been using Dr. Sheehan’s and Lecrubier’s e-M.I.N.I. for years to help diagnose my patients. This clinical interview scale has helped me unravel “treatment failure” mysteries (usually misdiagnosis) and the eM.I.N.I. documentation has protected me from professional liability lawsuits. You will not find this new suicidality clinical information elsewhere. Sheehan’s medical text is both a serious medical reference and a “pager-turner”.   A novel treatment for suicidality is suggested for study that is quite remarkable and readily available. I give this book an A-plus! Every clinician must have this book. I applaud Dr. Sheehan’s and Ms. Giddens’ achievement, which illuminates a critical area that our profession. The more people who read this, the more lives will be saved. I urge you to read this book immediately to improve your success.”Stephen M. Cox, MD; President & Medical Director, National Anxiety Foundation


“I was surprised when I read this book, especially as Dr. Sheehan, one of the two authors, discussed this book with me during a recent visit to China.  The authors have bravely offered a brand new concept and classification of suicidality, with detailed descriptions and evidence.  This book proposes not only a new theory about suicide, but also contains useful assessment tools to guide the readers in the assessment and monitoring suicidality in clinical practice.  Prediction, prevention, and intervention of suicide are always tough topics.  They are explored in case studies with thorough, complete, and detailed observations.  The approach taken by the book reminds us that traditional methods of research, like close observation, are as necessary as complex clinical trials.  This book also broadens our way of thinking about treating suicidality. I believe that this book will be a milestone for humanity to better understand suicidal ideation and behavior, and will further promote research about suicidality.”He Yanling, MD, MintMH; Shanghai Mental Health Center; Shanghai Jiao Tong University, School of Medicine


“I have had the pleasure of reviewing David Sheehan’s previous masterpiece, the Anxiety Disease. His new book on suicidality breaks a new record of precision and integration of data on suicide. Despite the availability of many effective treatments for treating the various underlying causes and dimensions of suicidality it is soaring in incidence and prevalence in this country and elsewhere, indeed soaring moods can be antecedents or aftermath of depression and/or anxiety. It remains an undefeated clinical and public health problem. It is also relevant to mention that anxiety does play an important role in both depression and suicidality. This oeuvre belongs in the library of physicians, psychiatrists and mental health professionals, justice system, social workers, clergy, epidemiologists, and lawyers and all those who are intimately involved with public health policy.” – Hagop S. Akiskal, MD (AΩA), h.c. (Lisbon, Aristotle U), DLFAPA, FACPsych (Emeritus), MRCPsych(hon,UK); Distinguished Professor of Psychiatry; University of California at San Diego; Director of International Mood Center; Editor-in-Chief Emeritus, Journal of Affective Disorders


Click here to purchase the eBook Suicidality: A Roadmap for Assessment and Treatment.