E2: Suicide Flashcards
Suicide is the ** leading cause of death in the US overall?
10th
Are men or women more likely to die via suicide?
Men are more likely to die from suicide, but women attempt more often
What are the risk factors for a suicide attempt?
- Previous suicide attempt is #1
- current and past psychiatric illness
- current symptoms
- family history
- stressors
- change in treatment
What psychiatric illnesses can increase risk of suicide?
- Previous suicide attempt
- mood disorders
- psychotic disorders
- substance abuse
- PTSD
- ADHD
- TBI
- Cluster B personality
- Conduct problem
What are often the symptoms of someone with SI?
- Anhedonia
- impulsivity
- hopelessness
- anxiety, panic
- insomnia
- command hallucinations
- psychosis
What family history can increase risk of SI?
- Completed suicide
- attempted suicide
- psychiatric hospitalization
- child abuse
What stressors can increase risk of suicide attempt?
- event causing humiliation, shame, or despair
- chronic pain
- sexual or physical abuse
- substance intoxication/withdrawal
- pending incarceration/homelessness
- legal problems
- inadequate social support
- perceived burden on others
What changes in psychiatric treatment can increase risk of suicide?
- recent psychiatric hospitalization (highest risk within 3 days, then within 30 days)
- change in provider or treatment
- hopelessness or dissatisfaction with treatment
- non-compliance or lack of treatment
What are the warning signs for suicide?
- Feeling like a burden
- being isolated
- increased anxiety
- feeling trapped or in unbearable pain
- increased substance abuse
- looking for a way to access lethal means
- increased anger or rage
- extreme mood swings
- expressing hopelessness
What observable traits that have high risk suspicion of SI?
- Agitation
- anxiety
- psychomotor activity
- emotional lability
- global insomnia
- appetite disturbance
- high level of distress
- desperation
- akathisia
What are the observable low risk traits of SI?
- Somnolent, sleepy
- calm
- hungry
- self directed actions
- Future directed actions
- Manipulative (if you dont *** I will kill myself)
What are the protective factors against a suicide attempt?
- Children at home
- sense of responsibility to family
- pregnancy
- religion
- life satisfaction
- positive social support
- effective clinical care
- support from providers
What is SAFE-T?
- Suicide Assessment Five-step Evaluation and Triage
- consistent of identifying risk and protective factors, conducting suicide inquiry, determining risk level, and documenting
What are the 4 important questions to ask when assessing for SI?
- Ideation? (Do you feeling like life is worth living?)
- Plan?
- Intent? (How likely and what prevents you?)
- Have you attempted suicide isn’t he past? How many times? What did you do? Etc
What are the importance questions to ask if a patient has SI and auditory hallucinations?
- Do the voices ever tell you to do specific things?
- Do they ever try to get you to hurt yourself?
What is the Columbia suicide severity rating scale?
-a questionnaire that is assesses risk and protective factors to determine the severity of SI
What are the potential challenges to assessing the severity of SI?
- Intoxicated patients
- threatened patients
- disagreement with recommendation
- countertransference issues (your feelings about the patient, wrong decision could be fatal, frustration with many attempts, or denial)
