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Year 4 - 2. Psychiatry > Mental state examinations, risk assessment and safeguarding > Flashcards

Mental state examinations, risk assessment and safeguarding Flashcards

1
Q

State the 2 types of risk to self

A
  1. Deliberate self-harm
  2. Suicide
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2
Q

State the M:F ratio of self-harm and peak age of incidence

A

M:F of 1:1.5 (more common in females), but varies depending on age

Female peak incidence: 15-19
Male peak incidence: 20-24

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3
Q

State the M:F ratio of suicide and peak age of incidence

A

M:F of 3:1 (more common in males)

Male peak incidence of 50-55

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4
Q

Identify risk factors for suicide

A

Medical:
- Previous suicide attempt
- Family history of suicide
- Mental illness
- Chronic physical illness
- Childhood abuse

Demographic/social:
- Male gender
- Age (40-45 in men)
- Single / living alone
- Unemployment
- Financial issues
- Recent significant life event
- Access to means

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5
Q

Identify risk factors for inpatient suicide

A
  • Previous suicidal behaviour
  • Presence of delusions
  • Violence to property
  • Forensic history
  • Recent bereavement
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6
Q

Identify risk factors for post-discharge suicide (after inpatient stay)

A
  • Suicidal behaviour prior to admission
  • Unplanned discharge
  • Lack of continuity of care
  • Unemployment
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7
Q

Suggest some factors that increase suicide risk in depression

A
  • Previous suicide attempts
  • More severe depression
  • Elderly
  • Self neglect
  • Hopelessness
  • Alcohol abuse
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8
Q

Suggest some factors that increase suicide risk in bipolar disorder

A
  • Male
  • First depressive episode
  • Illicit drug use
  • First degree family history of suicide
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9
Q

Suggest some factors that increase suicide risk in schizophrenia

A
  • Previous suicide attempts
  • Male
  • Early onset of disease
  • Depressive symptoms
  • High IQ
  • Positive symptoms e.g. hallucinations
  • Delay in treatment
  • Recent discharge from hospital
  • Substance abuse
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10
Q

Suggest some factors that increase suicide risk if someone engages in substance abuse

A
  • Previous suicide attempts
  • Male
  • Older age
  • Long duration of abuse
  • Use of alcohol / multiple substances used
  • Single
  • Comorbid depression
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11
Q

Which personality disorder has the highest risk of suicide and which is second highest

A

1st = emotionally unstable (borderline) personality disorder
2nd = narcissistic personality disorder

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12
Q

List some physical illnesses that increase the risk of suicide

A
  • Chronic disorders
  • Chronic pain
  • Cancer
  • HIV
  • Physical disability e.g. stroke, paralysis
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13
Q

List some methods of self-harm

A
  • Ingestion of toxins
  • Cutting
  • Burning
  • Punching
  • Scratching
  • Wound healing interference
  • Hair pulling
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14
Q

List the peak age of self-harm and whether it affects M:F more

A

11-25 years
Higher in females

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15
Q

List some risk factors for self-harm

A
  • Previous self-harm
  • History of trauma or abuse
  • Alcohol / drug misuse
  • Unemployment / low socioeconomic status
  • Forensic history / violence
  • Single
  • Chronic physical health problems
  • Severe life stressors
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16
Q

State some motives underlying deliberate self-harm

A
  • Wish to die
  • Communication
  • Unable to cope with thoughts/feelings
  • Temporary relief
  • Relieve sense of numbness
  • Punishment / sense of failure
17
Q

Suggest some potential management options for patients posing a risk to self for self-harm / suicide

A
  • Reduce access to means if possible
  • Treat any underlying psychiatric disorder
  • Further support in community e.g. crisis team
  • Inpatient admission
18
Q

State some risk factors for risk to others (e.g. homocide)

A
  • Dissocial personality disorder
  • Alcohol / drug misuse
  • Schizophrenia with delusions or hallucinations
19
Q

Briefly outline the levels of observation on the ward

A

Level 1 = general observation hourly, patients do not need to be kept in sight and are generally low risk to themselves and others (minimum level of observation for inpatients)

Level 2 = intermittent observation, every 5-30 minutes, for patients that pose a potential risk but not an immediate risk

Level 3 = continuous observation (within eyesight), nominated staff member allocated to observe at all times

Level 4 continuous observation (within arms length), nominated staff member allocated to observe at all times at close proximity

Year 4 - 2. Psychiatry (12 decks)

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