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Richard A. Parker, MD; Erin E. Hartman, MS
From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;285:1757.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

At Psychiatry Grand Rounds in February 2000, Douglas G. Jacobs, MD, discussed a suicidal 52-year-old man.¹ The patient, Mr D, almost jumped in front of a train after piling up gambling debts and losing his family's support. During a psychiatric hospitalization, Mr D related his history of compulsive gambling. He described his mood as "hopeless" with feelings of shame and guilt about his life failures. He received fluoxetine hydrochloride, 40 mg/d, and trazodone, 50 mg at bedtime. Due to refractory depression, he received a course of electroconvulsive therapy that continued after his discharge from the hospital.

Dr Jacobs described the epidemiology of suicide and explained its usual association with affective disorder, schizophrenia, or alcoholism. Dr Jacobs recommended using a suicide assessment protocol as a screening tool in general medical practice, and he explained which questions are crucial to ask of a potentially . . . [Full Text of this Article]

MR D, THE PATIENT



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