Deliberate Self Harm Flashcards
what is ‘attempted suicide’
non fatal deliberate self harm
what is a suicide without a mental illness
when someone makes the decision to die in sound mind
what mental illness do people who deliberately self harm usually have
NONE
depressed often at time of harm but its transient - no psychiatric illness
which gender has a higher suicide rate
male
what age is peak for suicide rates in low and middle income countries
early adulthood - 20s
what age is peak for suicide rates in high income counties
middle age
what are the most common methods of suicide in Scotland
hanging - (men)
self poisoning - (women)
when did suicide rates drop most in 1900s
world war 1 - greater sense of national community
world war 2- greater sense of community
1960s- due to change in gas supply to less toxic (sticking head in oven doesn’t cause death)
when did suicides peak in the 1900s
The Great Depression
1997 - after princess Diana’s death
what season has the highest suicide rate
higher in spring time
what season has the lowest suicide rate
autumn
occupations with highest suicide rates
doctors
dentists
farmers
unskilled labourers
what makes doctors, dentists and farmers suicide rates high
access to means
what physical illnesses have the highest risk of suicide
neurodegenerative diseases
chronic pain
how happens to CSF 5-HIAA in patients with Hx of self harm
decreased
what happens to prefrontal cortex activity in DSH patients
lower frontal activity
which mood stabiliser is associated with the highest suicide risk reduction
lithium
what gender is more likely do DSH
female - (young)
what is NSSI
non-suicidal self injury
self harm without intent of suicide - way to deal with extreme emotions
how is cholesterol related to DSH and suicide
low cholesterol increases rates
what is the strongest risk factor for suicide
Hx of deliberate self harm
who’s most likely to complete suicide after DSH
older male unemployed, NEET or retired single, separated or divorced isolated poor health psych Dx violent DSH suicide note hx of DSH
who’s most likely to repeat episodes of DSH
Previous DSH Personality disorder -OH or other drug abuse previous psych Rx unemployed low socioeconomic group criminal record 25-54 years of age single, separated, divorced
what are protective factors against suicide
religiousness
children
reason for living
what are motives for DSH
to die to escape anguish to escape a situation to display desperation to influence others to get back at others to get help to repeat what has helped before to roll the dice (see what happens)
biggest predictors of DSH/suicide
male
major mental illness
substance abuse
previous self harm
first stage management of suicidal patients
- calm the patient
- crisis cannot usually be resolved without some release of emotion
- crying - yes, aggression - no, be firm
- direct the interview, distract, deep breathing
second stage management of DSH/suicidal patients
Antecedents
ask about episode of self harm
ask about mental state then, and now
third stage of management
examine the immediate problems
fourth stage of management
bolster self esteem and problem solving
also form safety plan
fifth stage of management
arrange and explain follow up if this is indicated
