Deliberate Self Harm

Question 1

what is ‘attempted suicide’

Answer 1

non fatal deliberate self harm

Question 2

what is a suicide without a mental illness

Answer 2

when someone makes the decision to die in sound mind

Question 3

what mental illness do people who deliberately self harm usually have

Answer 3

NONE

depressed often at time of harm but its transient - no psychiatric illness

Question 4

which gender has a higher suicide rate

Answer 4

male

Question 5

what age is peak for suicide rates in low and middle income countries

Answer 5

early adulthood - 20s

Question 6

what age is peak for suicide rates in high income counties

Answer 6

middle age

Question 7

what are the most common methods of suicide in Scotland

Answer 7

hanging - (men)

self poisoning - (women)

Question 8

when did suicide rates drop most in 1900s

Answer 8

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)

Question 9

when did suicides peak in the 1900s

Answer 9

The Great Depression

1997 - after princess Diana’s death

Question 10

what season has the highest suicide rate

Answer 10

higher in spring time

Question 11

what season has the lowest suicide rate

Answer 11

autumn

Question 12

occupations with highest suicide rates

Answer 12

doctors
dentists
farmers
unskilled labourers

Question 13

what makes doctors, dentists and farmers suicide rates high

Answer 13

access to means

Question 14

what physical illnesses have the highest risk of suicide

Answer 14

neurodegenerative diseases

chronic pain

Question 15

how happens to CSF 5-HIAA in patients with Hx of self harm

Answer 15

decreased

Question 16

what happens to prefrontal cortex activity in DSH patients

Answer 16

lower frontal activity

Question 17

which mood stabiliser is associated with the highest suicide risk reduction

Answer 17

lithium

Question 18

what gender is more likely do DSH

Answer 18

female - (young)

Question 19

what is NSSI

Answer 19

non-suicidal self injury

self harm without intent of suicide - way to deal with extreme emotions

Question 20

how is cholesterol related to DSH and suicide

Answer 20

low cholesterol increases rates

Question 21

what is the strongest risk factor for suicide

Answer 21

Hx of deliberate self harm

Question 22

who’s most likely to complete suicide after DSH

Answer 22

older 
male 
unemployed, NEET or retired 
single, separated or divorced
isolated 
poor health 
psych Dx
violent DSH
suicide note 
hx of DSH

Question 23

who’s most likely to repeat episodes of DSH

Answer 23

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

Question 24

what are protective factors against suicide

Answer 24

religiousness
children
reason for living

Question 25

what are motives for DSH

Answer 25

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)

Question 26

biggest predictors of DSH/suicide

Answer 26

male
major mental illness
substance abuse
previous self harm

Question 27

first stage management of suicidal patients

Answer 27

• 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

Question 28

second stage management of DSH/suicidal patients

Answer 28

Antecedents
ask about episode of self harm
ask about mental state then, and now

Question 29

third stage of management

Answer 29

examine the immediate problems

Question 30

fourth stage of management

Answer 30

bolster self esteem and problem solving

also form safety plan

Question 31

fifth stage of management

Answer 31

arrange and explain follow up if this is indicated