DSH and suicide Flashcards
what is a rational suicide
suicide made with rational intent with absence of mental illness
where are suicide rates most high in UK
scotland
where are suicide rates higher and lower in europe
higher in eastern european and baltic countries
lowest in Mediterranean
true/false - females are more likely to take more aggressive forms of suicide such as hanging or jumping
false - females are more likely with less aggressive measures such as poisoning
what seasonal variation is present in suicide
peak in spring
trough in autumn
true/false - marriage increases suicide risk
false - it is the lowest of all relationship categories
what occupations are more likely to commit suicide and why
vets, doctors, farmers
access to means
what chronic illness is suicide more likely
neurological conditions
those involving stripping of dignity
what is a suicide pact
multiple people agree to all commit suicide
rarely completed
what is a murder suicide
person kills people close to them then kills themselves
true/false - lithium and clozapine are suicide protective
true
true/false - xmas is a protective suicide factor
true
true/false- males are more likely to commit DSH than females
false - females are but males have higher suicide rate
who is more likely to repeat DSH?
previous DSH personality disorder alcohol/drug abuse NEET low SE status criminal record 25-54 single, seperation, divorce
who is more likely to commit suicide after DSH
older patients males NEET, unemployed single, seperated, divorced isolation poor health psychiatric condition violent DSH Hx of DSH presence of a note
Overall management of DSH
calm pt
direct interview with privacy
ask about mental state, episodes DSH, antecedents
examine immeidate issues and who needs to know
bolster self esteem
arrange and explain follow up
risk factors of self harm
genes FHx ACEs psych hx depression personality disorder substance misuse physical health social support access to means hx of harm severity of past attempt hx of substance use age, ethnicity, relationship status stress tx adherence
exceptional physical risk factors of self harm
CHD, COPD, OA, asthma, Back pain, diabetes, HTN, stroke
HD
Visual impairment, cancer, neuro disorder
eating disorder
public health measures to reduce suicide risk?
restriction of paracetamol pack size
restricted location access
reduced ligature points
media guidance
SAD PERSONS content
Sex M Age <20 >44 Depression Previous attempt Ethanol Rational thinking loss Social support Organised? No spouse Sickness - chronic, severe
SAD PERSONS scoring
0-2 send home with follow up
3-4 close follow up with consideration to hospitalise
5-6 seriously consider hospitalisation
7-10 Hospitalise/commit
