Lecture 12-Suicide

Question 1

What are chronic and acute risk factors in suicide?

Answer 1

Chronic risk factors for suicide = things you cannot change = immutable

Acute risk factors for suicide = recent suicide attempts, recent suicidal behavior, substance abuse, insomnia, anxiety, agitation

Question 2

______ risk factors in suicide: older, male, white, jew or protestant, professional.

Answer 2

Increased

Question 3

Major precursor symptoms to suicidality =

Answer 3

insomnia, restlessness, hopelessness, & helplessness.

Question 4

People typically have Organized thought out plans to commit suicide And if you take away Part of the organization like take away a gun if Someone were to shoot themselves in the head typically they will _____ go through with it.

Answer 4

not

Question 5

A patient states that he has incessant thoughts that he cannot dismiss about dying, admits that he has seriously thought about driving his car into a bridge and has a plan to do this when his divorce is finalized this year. What is his risk level for suicide?

None
Low
Moderate
High

Answer 5

High

Question 6

A patient states that she has frequent and daily thoughts about suicide. She admits she has no imminent plan, but thinks an overdose would be peaceful. She states on a few occasions over the last year that she intended to take a handful of pills but could dismiss these impulses. This has not happened in a few months. What is her suicide risk level?

No risk
Mild
Moderate
Severe

Answer 6

Moderate

Question 7

Suicide is Almost always due to mental illness (95%), usually _______

Answer 7

depression

Question 8

In the elderly suicide ______ for women, ______ for men

Answer 8

decreases; increases

Question 9

Women attempt _____ suicide, but men are more ______.

Answer 9

more; successful

Question 10

In suicide:

African Americans have _____ rates than white Americans

Immigrants have _____ rates of suicide – both here and in their native countries

Answer 10

lower; higher

Question 11

Whites & native americans are ______ suicidal than latinos and blacks

Answer 11

more

Question 12

Suicide is ______ in married and _____ in divorced ppl

Answer 12

lower; higher

Question 13

Suicide is _____ in Catholic and Islamic Religions

Answer 13

Lower

Question 14

Suicide is ______ in professionals with doctors at the top

Answer 14

higher

most common in psychiatrists

Question 15

Suicide risk ______ with fall in social status or if you are unemployed

Answer 15

increases

Question 16

Suicide risk ______ especially the death of a parent by suicide or when the child was younger than 11 y/o

_______ risk if there is a loss of parent by divorce in adolescence

Answer 16

increases; increased

Question 17

What 2 mental diseases are most likely with suicide?

Answer 17

Depression (~80% of suicides)

Schizophrenia (10% of suicides)

Question 18

______ 5HT (serotonin) ALLELE PREVENTS SUICIDAL BEHAVIOR IN PEOPLE (PREVALENT IN BLACKS SO MAY BE CAUSE WHY THEY ARENT TOO SUICIDAL). The _____ allele increases risk for suicidal behavior.

Answer 18

LL long; ss or short

Question 19

What is the treatment protocol for suicide?

Answer 19

Add medication to quickly lower anxiety, insomnia, etc

Add slower acting antidepressants or psychotherapy

Increase support (family, more appointments, social supports) to increase connectivity, purpose, and to decrease helplessness, hopelessness

Question 20

If patient is high risk for suicide and patient does not want to be hospitalized he/she can be ________ for 1-63 days (exact duration depends on state law)

Physicians can be legally ______ if they do not recognize a suicidal patient or if they give a patient medicine that is later used in a suicide attempt

Answer 20

detained(committed); responsible

Question 21

Who is more likely to commit suicide?

A 22 year old depressive who has been on an antidepressant for some time and is very fatigued and has lost pleasure

A 22 year old depressive who feels jittery and anxious and just started and antidepressant

A 22 year old who has just started an antidepressant and has increased appetite, increased sleep, and rejection sensitivity

Answer 21

A 22 year old depressive who feels jittery and anxious and just started and antidepressant

They have recovered their energy so they could actually do it = acute risk factors

Question 22

Who is more likely to commit suicide?

A Catholic pediatrician who is married and has the LL SERT alleles

A Muslim orthopedist who is single and has Ls SERT alleles

A protestant psychiatrist who has ss SERT alleles

Answer 22

A protestant psychiatrist who has ss SERT alleles

SS = bad alleles

LL = protective

In psychiatry the little s gene for seotonin = bad

Question 23

A 28 year old obsessive-compulsive and bulimic patient tells you she is suicidal, what should you say?

OCD patients do not commit suicide without depression

Bulimics do not commit suicide as it is not a mood disorder

I have to commit you to the hospital or get a psych consult right now

Tell me more about those thoughts, they sound awful and distressing to you

Answer 23

Tell me more about those thoughts, they sound awful and distressing to you