Author Affiliation: Dr Jacobs is Associate Clinical Professor of Psychiatry, Harvard Medical School, Boston, and Executive Director, Screening for Mental Health, Wellesley Hills, Mass.
Clinical Crossroads Section Editor: Margaret
A. Winker, MD, Deputy Editor.
DR PARKER: Mr D is a 52-year-old man who, in
despair, almost jumped in front of a moving train. He attributes this episode
to gambling debts piled up in the prior 6 months and the ensuing conflict
with his family. He is a resident of Boston and has health insurance through
his blue-collar job.
Mr D describes a history of depression dating to his youth. He grew
up in a "tough" family, with a father who gambled and drank and brothers who
used drugs and alcohol. He has had suicidal thoughts on many occasions but
strongly contemplated suicide only once before when he was briefly held in
solitary confinement while in jail for a minor crime.
Jacobs DG. A 52-Year-Old Suicidal Man. JAMA. 2000;283(20):2693-2699. doi:10.1001/jama.283.20.2693