Clin Med - Suicide Flashcards

1
Q

State the percent of individuals who die by suicide who have visited their primary care physicians within a month of their death.

A

45%

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2
Q

Identify the two consistent psychological precursors to suicidal behavior.

A
  • feelings of hopelessness

- inability to make positive changes in one’s life

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3
Q

Compare the suicide and homicide rates in Oklahoma and in the United States.

A
  • suicide: Oklahoma=24.3%, USA=15.9%
  • OK suicide rate 3x homicide rate
  • US suicide rate 2x homicide rate
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4
Q

Identify which demographic group is at the highest risk of suicide.

A

White males > 85 years old

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5
Q

State the national rank of suicide as a cause of death in the United States.

A

10th leading cause of death (44,965 people)

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6
Q

State the leading suicide method.

A

61% Firearms: handguns > rifles > shotguns

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7
Q

Name the three domains in the Interpersonal Theory of Suicide that must overlap to create a strong risk for suicide.

A
  1. Thwarted Belongingness: feel isolated/like they don’t belong
  2. Perceived Burden
  3. Capability
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8
Q

Name the three leading circumstances associated with suicide in Oklahoma from 2012-2016.

A
  1. 44% –> 1+ diagnosed/treated mental health problem
    - Depression > bipolar > anxiety > schizophrenia > PTSD
  2. 34% –> intimate partner problem
  3. 31% –> current depressed mood
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9
Q

Identify the most common suicide circumstances in Oklahoma from 2012-2016.

A
  • Physical health problem
  • Substance abuse problem
  • Alcohol problem
  • Recent criminal legal problem
  • Job problem
  • Financial problem
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10
Q

Biopsychosocial risk factors for suicide

A
  • mental disorders
  • alcohol/substance use
  • hopelessness
  • impulse/aggressive tendencies
  • history of trauma/abuse
  • major physical illness
  • previous suicide attempt
  • family history of suicide
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11
Q

Environmental risk factors for suicide

A
  • job/financial loss
  • relational/social loss
  • easy access to lethal means
  • local clusters of suicide with contagious influence
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12
Q

Social risk factors for suicide

A
  • lack of social support
  • isolation
  • stigma associated with help-seeking
  • barriers to accessing healthcare/mental health/substance abuse
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13
Q

Cultural risk factors for suicide

A
  • cultural/religious beliefs

- exposure to and influence of others who died of suicide

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14
Q

State protective factors for suicide.

A
  • Effective clinical care for mental/physical/substance use
  • Easy access to variety of clinical interventions/support
  • Restricted access to highly lethal means of suicide
  • Strong connections to family/community support
  • Support through ongoing medical/mental healthcare relationships
  • Skills in problem solving, conflict resolution and nonviolent handling
  • Cultural/religious beliefs discouraging suicide and support self-preservation
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15
Q

Recognize the questions that may be asked when using the 2 Question Screen.

A
  • Are you thinking of hurting yourself?

- Are you thinking of killing yourself?

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16
Q

State the meaning of the letters QPR in relation to suicide prevention.

A

Q - question
P - persuade
R - refer

17
Q

Identify direct verbal clues that might be signs of a potential suicide attempt.

A
  • I’ve decided to kill myself
  • I wish I were dead
  • I’m going to commit suicide
  • I’m going to end it all
  • If “something” happens, I’ll kill myself
18
Q

Identify indirect verbal clues that might be signs of a potential suicide attempt.

A
  • I’m tired of life
  • What’s the point of going on
  • My family would be better off without me
  • Who cares if I’m dead anyway
  • I can’t go on anymore
  • I just want out
  • I’m so tired of it all
  • You would be better off without me
  • I’m not the man/woman I used to be
  • I’m calling it quits, living is useless
  • Soon I won’t be around
19
Q

Identify behavioral clues that might be signs of a potential suicide attempt.

A
  • Relapse into drug/alcohol after period of recovery
  • Purchasing gun
  • Stockpiling pills
  • Putting personal/business affairs in order
  • Making/changing will
  • Giving away money/prized possessions
  • Suspicious behavior (going out at odd times, waving/kissing goodbye)
  • Sudden interest/disinterest in church/religion
20
Q

Identify situational clues that might be signs of a potential suicide attempt.

A
  • Sudden rejection by loved one
  • Recent move (esp. if unwanted)
  • Death of spouse, child, friend (esp. if by suicide/accident)
  • Terminal illness diagnosis
  • Sudden unexpected loss of freedom
  • Anticipated loss of financial security
  • Loss of cherished counselor/therapist
21
Q

Identify indirect questions that may be used in the QPR technique with a patient who may be at risk to die from suicide.

A
  • Have you been unhappy lately?
  • Have you been very unhappy lately?
  • Have you been so very unhappy you wish you were dead?
  • Do you ever wish you could go to sleep and never wake up?
  • You know, when people are as upset as you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way too.
22
Q

Identify direct questions that may be used in the QPR technique with a patient who may be at risk to die from suicide.

A
  • Have you ever wanted to stop living?
  • You look pretty miserable. Are you thinking of killing yourself?
  • Are you thinking about suicide?
23
Q

Name the most important skill that one must develop and use after asking indirect or direct questions to an individual who may be at risk to die from suicide.

A

*Listening

To become better at listening:

  • Give your full attention
  • DO NOT interrupt, speak only when the other person has finished
  • DO NOT rush to judgement/condemnation
  • Tame your own fear, focus on the other person
24
Q

State the guidelines for an effective referral.

  • best
  • next best
  • third best
A
  • Best referrals: you personally make appointment at take person to mental health provider.
  • Next best: personal agrees to see professional so you can follow up later and know they kept the appointment.
  • Third best: getting person to agree to accept help, even if in the future, and providing them specific referral information.