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Emergency Psych Flashcards

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1
Q

Derived from the latin word which means self murder

A

Suicide

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2
Q

A spectrum where people just think about it and neved do anything, but there are some who killa themselves

A

Suicide

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3
Q

In psychiatry, suicide is…

A

A primary emergency

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4
Q

Suicide

A

Optimum care but the patient may still die
Impossible to predict
Almost always a result of mental illness

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5
Q

Most common mental ilnness associated with suicide

A

Depression

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6
Q

Prime suicide site in the world

A

Golden gate bridge in san francisco

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7
Q

Suicides committed since the bridgd opened in 1937

A

1600 suicides

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8
Q

2nd most common leading cause of death

A

Suicide

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9
Q

Age of most suicides

A

15-29 yrs old

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10
Q

Nunber of yearly death by suicides

A

800 000

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11
Q

1 death occurs every

A

40 seconds

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12
Q

Percentage where suicides occur in low income countries

A

79%

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13
Q

Most common methods used in suicides globally

A

Pestocides, hanging, firearms

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14
Q

Are suicides preventable? Yes or no

A

Yes

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15
Q

Effective prevemntive measures in suicides

A

Restricting access to means
Responsible media reporting
Introducing alcohol policies
School based interventions
Training of health workers in early identification and treatment
Follow up care and community support

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16
Q

Most countries currently have a national suicide prevention strategy

A

No

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17
Q

Percentage in the WHO mental health action plan 2013-2020

A

10%

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18
Q

FRACTION in the UN sustainable development goals 2030

A

1/3

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19
Q

Risk factors in suicide

A

Gender
Age
Religion
Marital status
Occupation
Physical health
Mental illness psychiatdic px

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20
Q

Commit suicide 4x as often as women

A

Men

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21
Q

Attempt suicide or have suicidal thought 3x as often as men

A

Women

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22
Q

More likely to commit suicide

A

Men

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23
Q

Uses firearms, hanging or jumping from high places

A

Men

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24
Q

More commonly take an overdose of psychoactive substances or poison

A

Women

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25
Q

Most common method used in suicide

A

Hanging

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26
Q

For all age vrouls suicide is rare before

A

Puberty

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27
Q

Suicide rate ___ with age

A

Increase

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28
Q

Among men suicide peaks after

A

45 yrs old

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29
Q

Among women, more completed suicides occur after

A

55 yrs old

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30
Q

Older persons attempt suicide

A

Less

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31
Q

Older persons attempt suicide less but

A

Are more successful

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32
Q

T/f : older people are more ambivalent and their mind tend to not get fixed and they are not thingking of wanting to die

A

False

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33
Q

Degree of orthodoxy and integration

A

Religion

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34
Q

More accurate measure of risk in this category than simple institution

A

Degree of orthodoxy and integration

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35
Q

Adherecs t correct or accepted creeds in religion

A

Orthodoxy

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36
Q

Lessens risk of suicide especially if there are children at home

A

Marriage

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37
Q

Register an overall rate nearly double that of married couples

A

Single, never married persons

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38
Q

Increases suicide risk especially in men

A

Divorce

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39
Q

3x more likely to kill themselves after divorce

A

Men

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40
Q

Have high rates of suicides when loved one died

A

Widow, widowers

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41
Q

Suicide occur more frequently in persons who are socialized but have a family history of suicides

A

False should be socially isolated

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42
Q

People who take their lives on the day a member of their family did

A

Anniversary suicides

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43
Q

Homosexuals appear to have higher rates of suicides

A

True

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44
Q

In general protects against suicide

A

Work

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45
Q

The higher the persons social status the less risk of suicide

A

False higher

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46
Q

Drop in social status decreases risk of suicide

A

False inc

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47
Q

Greatest risk of suicide among professions

A

Physicians

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48
Q

Other professions at risk

A

Law enforcement, dentist, artist, mechanics, lawyers, insurance agent

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49
Q

Ophthalmologisy are considered to be at greatest risk of suicide

A

False dapat psychiatrist, 2nd ophthal, 3rd anesthesiologist

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50
Q

Had medical attention within _ months of death

A

6 months

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51
Q

About _ of all who commit suicide

A

1/3

52
Q

Estimated to be important contributing factor in 1/2 of all suicides

A

Physical illness

53
Q

Physical illnesses that lead to suicide

A

Loss of mobility, disfigurement, intractable chronic pain

54
Q

Alcohol have higher rates of suicides

A

True

55
Q

Diagnosed mental disorder is _ of all persons who sommit or attempt suicide

A

95%

56
Q

Percentage of depressive disorder

A

80%

57
Q

Percentage of schizophrenia

A

10%

58
Q

Dementia or delirum

A

5%

59
Q

Among person with mental disorder _ are alcohol dependent

A

25%

60
Q

A history of impulsive behavior or violent acts that are at highest risk of suicide

A

Persons with delusional depression

61
Q

Age of diagnosed substance abuse and antisocial personality disorder

A

Less than 30 yrs old

62
Q

Diagnosed of mood disorder and cognitive disorder

A

More than 30 yrs old

63
Q

_ risk for suicide of psychiatric px than of non patients

A

3-12x

64
Q

Male and female psychiatric in patients

A

5-10x ĥigher

65
Q

Never been admitted

A

3-4x

66
Q

Tend to be hospitalized

A

Severe mental disorder

67
Q

Psychiatric diagnosis of greatest risk

A

Mood disorders

68
Q

Best indicator that a patient is at increased risk of suicide

A

Previous suicide behavior

69
Q

Studies shows that about _ of depressed patients who commit suicide have made previous attempt

A

40%

70
Q

Within _ months of first attempts

A

3 months

71
Q

Highest risk of a second suicide attempt, must tell the family to be on guard

A

Within 3 months of first attempt

72
Q

French social scientist , widely regarded as the founder of french school of sociology

A

Emile durkheim

73
Q

Emile durkheim has 3 categories

A

Altruism
Egoistic
Anomic

74
Q

Not strongly integrated into any social groups

A

Egoistic

75
Q

Suicide stemming from excessive integration into social group

A

Altruistic

76
Q

Integration into society is disturbed so that they cannoth follow customary norms of behavior. Also there is breakdown of social values

A

Anomic

77
Q

Theory of mourning a d melancholia by sigmund freud

A
78
Q

Aggression turned inward against introjected ambivalenty cathected love object

A

Mourning and melancholia

79
Q

Theory of man against himself

A

Karl meningers theory

80
Q

An american psychiatrist, an advocate of social justice and the founder of meninger school of psychiatry

A

Karl meninger

81
Q

Suicide as inverted homicide because of a patient’s anger towrcs another person

A

Man against himself

82
Q

Freuds concept of thanatos

A

Self directed death instinct

83
Q

Components of hostility in suicide

A

Wish to kill
Wish to be killed
Wish to die

84
Q

They believe that much can be learned abkut psychodynamics of suicidal patients from their fantasies about what would happen and the consequences if they commnit suicide

A

Contemporary suicidologist

85
Q

May experience kverwhelming affects like rage and guilt, may also identify with a suicide victim

A

Lost a love object or recieved a narcissistic injury

86
Q

Undelie mass suicides such as those at masada or jonestown buy the heavens gate cult

A

Group dynamics

87
Q

Biological Factors

A

Low 5-hydroxyindoleacetic

88
Q

Tends to run in the family

A

Suicidal behavior

89
Q

Have significantly higher concordance
for both suicide and attempted suicide

A

Monozygotic twin pairs

90
Q

Have two (2) alleles: U and L_

A

Tryptophan Hydroxylase (TPH)

91
Q

Presence of _ is associated with:
> Increased risk of suicide attempts
> Repetitive suicidal behavior

A

L allele

92
Q

Reduced capacity to hydroxylate
‘Tryptophan to 5-HT in the synthesis of
Serotonin results t

A

Low central serotonin turnover

93
Q

Patients who injure themselves by self-mutilation but who
usually

A

Parasuicidal behavior

94
Q

Parasuicidal behavipr female to male ratio

A

3:1

95
Q

Parauicidal behavior incidence among psych px

A

50 times more than the general population

96
Q

_ have cut themselves over several years due to their:
o Anger at themselves or others, and
o Relief of tension or wish to die
o Alcohol and other substance abuse are common
o Most cutters have attempted suicide

A

Cutters

97
Q

Cutters cut coarsely not delicately

A

False the other way around

98
Q

Cutters usually cut with a

A

“Razor blade, knife, broken glass/ mirror

99
Q

Cutters commonly cut their

A

Wrist arms thighs and legs

100
Q

Cutters infrequently cut their

A

Face breast abdomen

101
Q

Most cutters claim to experience pain

A

False no pain

102
Q

Prediction of para suicide

A

Done via clinical exam

103
Q

High risk characteristics of suicide

A

Male
45 yrs old
Alcohol dependence
Violent behavior
Prev. Suicidal behavior
Prev psychiatric hospitalization

104
Q

«The suicide rate is 50 times higher than
to those who are not

A

Alcohol dependence

105
Q

Questions about suicidal feelings and behaviors are asked

A

Directly

106
Q

Most suicides among psychiatric patients are not preventable

A

False preventable

107
Q

Itis often associated with suicide

A

Inadequate assessment or treatment

108
Q

Suffering so great and intense, or chronic and unresponsive
to treatment —uncommon

A

Inevitable suicide

109
Q

Other patients have the following dse at risk for suicide

A

Severe Personality Disorder
o Highly impulsive & commit suicide spontaneously
o Often when dysphoric, intoxicated or both

110
Q

Evaluation for suicide

A
  • Complete Psychiatric History
  • A thorough Mental Status Examination (MSE)
  • Inquiry about Depressive symptoms, suicidal thoughts,
    intents, plans, and attempts
111
Q

Increased risk of suicide are implied on the following

A

o A lack of future plans
o Giving away personal property
o Making a will, and
o Recently experienced a loss

112
Q

Decision to Hospitalize

A
  • It depends on the diagnosis
    : The severity of Depression
    : Suicidal ideation
  • The patient and the family’s coping abilities
    : Patient’s living situation
    : The availability of social support
  • The absence or presence of risk factors for suicide
113
Q

Outpatient

A
  • Ask patients who are considered suicidal to agree to call
    o When they become uncertain about their ability to
    control their suicidal impulses
    Patients who can make such an agreement with a doctor
    with whom they have a relationship
    o It reaffirms the belief that they have sufficient
    strength to control such impulses and to seek help
    ‘In return for a patient’s commitment, clinicians should be
    available to the patient 24 hours a day
114
Q

‘In return for a patient’s commitment, clinicians should be
available to the patient

A

24 hrs

115
Q

Preventive Measures for dealing with a Suicidal Person

A

Reducing the psychological pain By modifying the patient’s stressful environment
: Enlisting the aid of the spouse employer friend
: Building a realistic support
: Offering alternatives to suicide

116
Q

They are difficult to treat and exhaust caretakers
- Constant observation by special nurses

A

Chronically suicidal px

117
Q

Seclusion and restraints cannot prevent suicide
when a patient is resolute ./ or when pxis determined to do it

A

Constant observation by special nurses

118
Q

may be necessary for some severely Depressed patients

A

Ect

119
Q

procedure in which small
electric currents are passed through the brain triggering a brief
seizure as a treatment for Depression & other psychiatric conditions

A

Et

120
Q

Suicide px should be treated with Vigorous treatment with

A

antidepressant or antipsychotic , supportive therapy

121
Q

PX should be persuaded from making major life decisions while they are suicidally depressed

A

False disuaded

122
Q

o They are at a particular risk
o As the Depression lifts — patients become
energized and are able to put their suicidal plans into action

A
  • Patients recovering from a suicidal Depression
123
Q

Paradoxical Suicide activating the effect of

A

Serotonergic drugs

124
Q

suddenly appear to be at peace — they
have reached a secret decision to commit suicide

A

Paradoxical Suicide

125
Q

Although common, some patients lie to the Psychiatrist
about their suicidal intent

A

False rare

126
Q

Persons receiving treatment for a psychiatric disorder

A

Inevitable suicide

PSYCH (4 decks)

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