Assessment of Dangerousness Flashcards
Risk factors for suicide
major depression (accounts for 50%) alcoholism and drug dependence (50%) schizophrenia personality disorders medical risk factors family and genetic factors social risk factors
how often are suicides successful?
once out of every 8-10 attempts
age most likely to commit suicide
15-24 years
>60 years
gender
women 3x more likely to attempt
men 3x more likely to complete
biological markers
decreased CSF level of 5HT and 5-HIAA
HPA axis hyperactivity
treatment for decrease risk of suicide
lithium
clozapine
ECT
not proven to decrease overall suicide risk
SSRIs
even a week’s supply of some antidepressants
can be lethal
4 things to monitor
intentionality- what is the level of expressed intention?
lethality- does the patient have a plans? How lethal is the plan?
Means- does the patient have th emeans to carry out their plan?
Viability- What is the ability of the patient to accept help and hope?
Tarasoff Warning
duty to warn intended victim
duty to protect intended victim
aggression
overt behavior involving intent to inflict noxious stimulation or to behave destructively towards another organism
may be impulsive or premediated
agitation
state of poorly organized and aimless psychmotor activity- stems from a state of physical and mental unease
emergency
red flags for likely medical cause
new onset agitation ina dult over age 45 with no psych histroy
not consistent with known psych history
abnormal vital signs
abnormal PE findings
signs/sx of drug/alch intox
signs/sx of drug/alch withdrawal
confusion, disorientation, deficits in attn and cognition
cycles of de-escalation
listen to patient
find a way to agree with/validate patient
state what you want the patient to do
a drug is considered a restraint when
used to restrict behavior or movement and is not a standrad treatment or dosage for condition
