CM: Suicide Flashcards
What are common misconceptions about suicide?
talking about suicide increases feelings of depression and suicidal behavior - it does not
low functioning or crazy people attempt suicide - not true
relationship b/w media coverage of high profile suicides and rates of suicidal behavior? yes
month w highest suicide rate? April
What is suicidal ideation?
thought’s of causing ones own death
spectrum differentiated by specificity, frequency, intensity and intent of thoughts
What is suicidal intent?
death is intended result of person’s actions
does not address concept of medical lethality (doesn’t matter if what they did is actually medically dangerous, only intent matters)
What is non-suicidal self-directed violence?
evidence that person did NOT intend to kill themself
What is the gender and ethnicity of the majority of all individuals who complete suicide in the US annually?
women more likely to attempt, men more likely to complete (and use more violent methods)
absolutely mostly Caucasian
relatively (rates) higher among US American Indian/Alaskan native adolescent adults
lower rates for Hispanic and African-American
What is the geographic region, age, and psychiatric illness associations of suicide?
more in Western states
more under 30 attempt, more over 45 succeed
90% have confirmed psychiatric illness
What is important about suicide victims and contact w medical professionals?
45% of suicide victims had contact with PCP w/i 1 mo of suicide, 77% had contact w/i 1 yr
What are three potential explanations for increased risk of suicide-related deaths found among physicians?
attitudes discourage admission of vulnerabilities
more likely to have had recent job-related stressor
physicians more likely to overdose as method
What are important practices when a pt is prescribed an antidepressant?
close monitoring, do not abruptly stop, educate family and pts about suicide and warning signs
What are factors that may increase the risk of intentional self harm in a suicidal individual?
age and gender (older white males), history of suicide attempts, prior suicidal ideation, hx of self-directed violence, family hx of suicide or suicidal behavior, hx of trauma or abuse, hx of psychiatric hospitalization, separated, divorced or significant marital conflict
What are five ACUTE risk factors that may increase the risk of intentional self harm in a suicidal individual?
current ideation, intent, plan, access to means
recent suicide attempt
recent self-harm behavior
hopelessness - presence, duration, severity
recent discharge from inpatient pysch unit
What are three factors that may decrease the risk of intentional self harm in a suicidal individual?
positive social support
spirituality
children in home, pregnancy
When is immediate action required (pt at imminent risk for suicide)?
verbal threats to hurt or kill self
someone looking for ways to kill themself (access to means)
someone preoccupied w death, dying or suicide
When is referral to a mental health provider for outpatient evaluation appropriate?
symptoms of depression and/or passive suicidality
hopelessness, rage, seeking revenge, reckless or risky behavior, increasing drug or alcohol use, withdrawing from friends and family or work, anxiety, irritability, changing sleep patterns, changes in mood, unable to articulate reason for living or purpose in life
Who are pts that should be routinely screened for suicide risk?
symptoms of depression or mania
present w hx of mental illness
present w any warning signs
active-duty military recently returned from combat
recent release from inpatient psych facility
