Emergency Psychiatry Flashcards
How many deaths in E+W are due to suicide?
1%
How many patients with mood disorder will die by suicide?
6-10%
Risk factors for suicide in patients with depression
History of impulsive and aggressive behaviour
Cluster B PD
History of attempted suicide - increases risk by 40x
Alcohol and drug use
Lifetime risk of suicide in those with alcohol dependence
7%
Risk of suicide in anorexia
20x higher than general population
Lifetime risk of suicide in SCZ
6% - 10x higher than general population
Most common in active phase of disorder after depressive sx
M:F ratio of suicide
2-4:1
Most common age groups who commit suicide
15-24 females
25-34 males
Most common mental illness in those who commit suicide
Depression 30-31%
Alcohol dependence 17-24%
How many people who self-harm will self-harm again in one yer
30%
How many people who commit suicide have at least one previous recorded DSH attempt
40-60%
How may people who commit suicide were in contact with MH services within a year of death
25%
How many attempt suicide while under influence of alcohol
25%
How many people who commit suicide saw a psychiatrist in last week
12.5%
How many people who commit suicide in inpatients committed suicide in first week of admission
25%
How many people who committed suicide were discharged from inpatients within 3 months
25%
40% of these occurred before first follow up
Preventable suicides in E+W according to MH teams
22%
Strongest risk factor for suicide
DSH history
Risk of suicide within one year of DSH
Males 1.1%
Females 0.5%
66x gen pop risk
How many inpatient suicides occurred while on leave?
33%
Prevalence of suicidal ideation
9.2%
Prevalence of suicidal plans
3.1%
Prevalence of suicide attempts
2.7%
Rate of self-harm
3 per 1000 per year
How many people who self-harm will repeat in the next year
20%
How many people who self-harm will eventually commit suicide
10%
Environmental treatment for confused/delirious patients
Promoting the presence of familiar people in the
vicinity
Using well-lit nursing bay, Using frequent reorientation to place and purpose,
Providing one-to-one nursing, encouraging adequate fluid and food intake,
Avoiding
polypharmacy including routine sedatives and other agents that can worsen confusion
e.g.anticholinergics.
Haloperidol doses for delirium
0.5mg in elderly
2mg in adults
Can repeat after 2 hours
