Deliberate Self-Harm Flashcards
Do all people who commit suicide have a psychiatric illness?
No
Which relationship status is associated with the lowest suicide risk?
Marriage
Which professions have the highest rates of suicide?
doctors, farmers, vets
Why do doctors, farmers and vets have a higher risk of suicide?
Conferred by access to means - drugs, shotguns etc.
Does integration in society play a part in suicide risk?
yes - greater sense of integration, lower risk
What is seen in prefrontal cortex activity in DSH patients?
reduced activity
Is there a genetic link between suicide?
yes - monozygotic twins are higher than dizygotic, are higher than single.
What is the ratio of deliberate self-harm to suicide?
10-20:1
Is DSH more common in females/males?
females
Which socio-economic status has higher rates of DSH?
low
What percentage of suicides have a history of DSH?
40%
What is the single greatest risk factor for suicide?
history of DSH
who suicides after DSH?
older male unemployed single/separated/divorce isolated poor health psychiatric history suicide note history of DSH
What are some possible motives?
to die escape anguish escape a situation display desperation/get help influence others/get back at others roll the dice...
What significance is hopelessness in DSH/suicide?
a robust predictor of eventual fatal self-harm
include hopelessness in your MSE
What is the immediate management in DSH/suicide?
calm the patient
crisis cannot usually be resolved without some emotional release
be firm but supportive
direct the interview - privacy, distract, deep breathing.
What is it important to ask about?
antecedents - what led up to the event
the episode of self-harm
mental state then and now
How can you bolster self-esteem and help problem solving?
look for past episodes and use as a template
use family and friends
How can manipulative patients use the threat of suicide?
to change their environment
1 Dependent clingers
2 Entitled demanders
3 Manipulative help-rejecters
4 Self-destructive deniers
compromise, boundaries
What is suicidal ideation vs suicidal intention?
A patient can think about suicide but will never do it, whereas intention implies wanting to take ones life.
