Emergency Psychiatry

Question 1

How many deaths in E+W are due to suicide?

Answer 1

1%

Question 2

How many patients with mood disorder will die by suicide?

Answer 2

6-10%

Question 3

Risk factors for suicide in patients with depression

Answer 3

History of impulsive and aggressive behaviour
Cluster B PD
History of attempted suicide - increases risk by 40x
Alcohol and drug use

Question 4

Lifetime risk of suicide in those with alcohol dependence

Answer 4

7%

Question 5

Risk of suicide in anorexia

Answer 5

20x higher than general population

Question 6

Lifetime risk of suicide in SCZ

Answer 6

6% - 10x higher than general population

Most common in active phase of disorder after depressive sx

Question 7

M:F ratio of suicide

Answer 7

2-4:1

Question 8

Most common age groups who commit suicide

Answer 8

15-24 females

25-34 males

Question 9

Most common mental illness in those who commit suicide

Answer 9

Depression 30-31%

Alcohol dependence 17-24%

Question 10

How many people who self-harm will self-harm again in one yer

Answer 10

30%

Question 11

How many people who commit suicide have at least one previous recorded DSH attempt

Answer 11

40-60%

Question 12

How may people who commit suicide were in contact with MH services within a year of death

Answer 12

25%

Question 13

How many attempt suicide while under influence of alcohol

Answer 13

25%

Question 14

How many people who commit suicide saw a psychiatrist in last week

Answer 14

12.5%

Question 15

How many people who commit suicide in inpatients committed suicide in first week of admission

Answer 15

25%

Question 16

How many people who committed suicide were discharged from inpatients within 3 months

Answer 16

25%

40% of these occurred before first follow up

Question 17

Preventable suicides in E+W according to MH teams

Answer 17

22%

Question 18

Strongest risk factor for suicide

Answer 18

DSH history

Question 19

Risk of suicide within one year of DSH

Answer 19

Males 1.1%
Females 0.5%
66x gen pop risk

Question 20

How many inpatient suicides occurred while on leave?

Answer 20

33%

Question 21

Prevalence of suicidal ideation

Answer 21

9.2%

Question 22

Prevalence of suicidal plans

Answer 22

3.1%

Question 23

Prevalence of suicide attempts

Answer 23

2.7%

Question 24

Rate of self-harm

Answer 24

3 per 1000 per year

Question 25

How many people who self-harm will repeat in the next year

Answer 25

20%

Question 26

How many people who self-harm will eventually commit suicide

Answer 26

10%

Question 27

Environmental treatment for confused/delirious patients

Answer 27

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.

Question 28

Haloperidol doses for delirium

Answer 28

0.5mg in elderly
2mg in adults

Can repeat after 2 hours