Deliberate Self Harm

Question 1

What are the different risk factors for suicide?

Answer 1

Gender
Geography 
Affluence 
Access to methods to suicide
Seasons (people born in spring are more likely to commit suicide) 
Time 
Marital status 
Occupation

Question 2

Did suicide rates increase/decrease during Covid pandemic? Why?

Answer 2

Decrease because of sense of national cohesion facing joint threat

Question 3

What 3 occupations have the highest suicide rates and for what reason?

Answer 3

Vets
Doctors
Farmers
-most likely due to cos of access to means

Question 4

Studies found that patients with history of DSH had dysregulated ____ when compared to control sample. They also found that patients with high-lethality DSH had reduced ____ than patients with low-lethality DSH.

Answer 4

Serotonin

Reduced prefrontal cortex activity

Question 5

Males are more likely to self harm & the most common is method is self-laceration. True/false?

Answer 5

False - females more likely and most common method is poisoning

Question 6

What percentage of suicides have history of DSH?

Answer 6

40%

Question 7

What is the biggest risk factor for suicide?

Answer 7

DSH

Question 8

The rate of suicide in the next 12 months after DSH is 1%. True/false?

Answer 8

True

Question 9

What is the actuarial approach to patients and suicide?

Answer 9

THe closer a patient comes to the profile of a suicide completer, the higher the risk of that person carrying out suicide

Question 10

What factors make a patient more likely to repeat DSH?

Answer 10

• previous DSH
• previous psych problems
• personality disorder
• substance abuse
• unemployed
• low socioeconomic group
• 25-54
• single, separated or divorced

Question 11

What factors are common in those who complete suicide after DSH?

Answer 11

• older
• male
• unemployed
• single, separated, divorced
• isolated
• poor health
• psych history

Question 11

What factors are common in those who complete suicide after DSH?

Answer 11

• older
• male
• unemployed
• single, separated, divorced
• isolated
• poor health
• psych history

Question 12

What are some problems with the actuarial approach?

Answer 12

ecological fallacy (just cos you're part of population doesn't mean it's true to you) 
Stability of risk factors (can change)
Commonality of risk factors e.g. smoking common 
false positives really high

Question 13

What are motives for self harm?

Answer 13

to die
to escape pain
to get help

Question 14

What should be your management plan when seeing a patient who has DSH?

Answer 14

• ensure patient is now medically safe
• psychiatry history
• social history
• medical history
• psychiatric formulation
• get patient to talk you through self harm event

Question 15

What is the psychiatric formulation?

Answer 15

• An understanding of a patient’s current situation

* predisposing factors, precipitating event, perpetuating factors

Question 16

What is the biopsychosocial model?

Answer 16

Used to determine areas of patients mental health that may worsen it.
biological e.g. disease, disability
psychological e.g. self esteem, coping skills
social e.g. isolation, family

Question 17

What are some management approaches to DSH/suicide?

Answer 17

• create rapport with patient & use good language e.g. suicidal ideation/intention
• psychiatry/psychology
• counselling
• social work
• look for past episodes where they have solved
• bolster self esteem - this takes bravery to discuss this with me