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Correspondence
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Volume 338:261-262 January 22, 1998 Number 4
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Treatment of Suicidal Patients

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 by Hirschfeld, R. M.A.
To the Editor: Hirschfeld and Russell's algorithm for treating suicidal patients (Sept. 25 issue)1 does not emphasize the fundamental importance of psychodynamic formulation and brief psychotherapy in clarifying and managing a suicidal crisis. Although major depression, alcohol abuse, and other psychiatric conditions have been shown to figure prominently in suicidal states, recent blows to self-esteem or disruptions of key relationships may explain why a particular patient presents in crisis at a specific time.2 Moreover, some patients, particularly those with certain personality disorders, may be so sensitive to losses that the resulting reactive depressive states may prove no less deadly than . . . [Full Text of this Article]

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