David Lester

Stockton University, Psychology, Emeritus

Followers

164

Following

Co-authors

Public Views

My primary interest has been suicidal behavior, but I have also published on murder, the fear of death and life after death. My other major interest is theories of the mind (theories of personality), and I have a new theory proposing that the mind is made up of several subselves.

less

Eleonora De Pisa

John McIntosh

Indiana University South Bend

King's College London

Philip Beh

Silke Schurack

University of Iceland

Dr Nadine Kaslow

Emory University

Interests

Uploads

Papers by David Lester

Suicide risk in schizophrenia: learning from the past to change the future

by Merete Nordentoft and David Lester

Annals of General Psychiatry, 2007

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at l... more Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5-13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general

Download

Suicide risk in first episode psychosis: A selective review of the current literature

by Merete Nordentoft and David Lester

Schizophrenia Research, 2011

Many studies have confirmed that the risk of suicide in patients with first-episode psychosis (FE... more Many studies have confirmed that the risk of suicide in patients with first-episode psychosis (FEP) is high, and high rates of premature mortality, particularly from suicide, may occur in the early phases of schizophrenia. However, suicide rates are difficult to measure in FEP patients, even in carefully defined samples, and there is relatively little specific information about the risk of suicide at illness onset or retrospectively concerning the untreated psychotic period. This selected review of the literature investigates suicidal behaviour with particular regard to severe suicidality (plans and attempts) and risk factors associated with suicide in FEP patients. A search was performed to identify all papers and book chapters during the period 1965-2010, and approximately 100 studies met the inclusion criteria. Most of evidence suggests that risk of suicidal behaviour is relatively high in FEP patients. The research reports highlight the need for universal, comprehensive, public mental health interventions aimed, not only toward early detection, but also toward the rapid engagement in treatment of people with psychoses. These interventions should include an adequate assessment of suicidal behaviour in patients with FEP, and an examination of the efficacy of specific components of the interventions.