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2. General adult psychiatry > Psychiatric emergencies > Flashcards

Psychiatric emergencies Flashcards

1
Q

Percentage of global mortality due to suicide

A

1-2%

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2
Q

Suicides per 100,000 per year

A

8 per 100,000

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3
Q

Demographic in which suicide rates are increasing

A

Young men

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4
Q

Most common method of completed suicide among men

A

Hanging

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5
Q

Percent of male suicides caused by hanging

A

40%

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6
Q

Percent of male suicides caused by OD

A

20%

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7
Q

Percent of male suicides caused by self poisoning by car exhaust fumes

A

10%

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8
Q

Most common method of female suicide

A

OD

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9
Q

Percent of female suicides caused by OD

A

46%

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10
Q

Percent of female suicides caused by hanging

A

27%

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11
Q

Percent of female suicides caused by drowning

A

7%

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12
Q

Age with highest rate of suicide in most countries

A

> 75

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13
Q

Ethnic demographic in the UK with particularly high suicide rates among women

A

Asian

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14
Q

Types of doctor at highest risk of suicide

A

Anaesthetists
GPs
Psychiatrists

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15
Q

Sex with highest excess suicide rate among doctors

A

Women

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16
Q

Percentage of patients with completed suicide who had depression

A

36-90%

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17
Q

Percentage of patients with completed suicide who had alcohol misuse

A

43-54%

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18
Q

Percentage of patients with completed suicide who had drug abuse

A

4-45%

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19
Q

Percentage of patients with completed suicide who had schizophrenia

A

3-10%

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20
Q

Percentage of patients with completed suicide who had an organic mental disorder

A

2-7%

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21
Q

Percentage of patients with completed suicide who had a personality disorder

A

5-44%

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22
Q

Percentage of patients with a mood disorder who will die by suicide

A

6-10%

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23
Q

Factors which increase the risk of suicide among people with depression

A

History of impulsive or aggressive behaviour
Alcohol and drug misuse
Cluster B personality disorders
History of attempted suicide

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24
Q

Most important risk factors which increase the risk of suicide among patients with depression

A

History of attempted suicide or DSH

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25
Q

Increase in risk of suicide among people with a history of attempted suicide

A

40x higher

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26
Q

Lifetime risk of suicide among people with alcohol dependence

A

7%

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27
Q

Increased rate of suicide among people with alcohol use disorders compared to the general population

A

10x higher

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28
Q

Increased rate of suicide among people with drug dependence or abuse compared to the general population

A

15x higher

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29
Q

Increased rate of suicide among people who drink heavily compared to the general population

A

3.5x higher

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30
Q

Increased rate of suicide among people with anorexia nervosa than the general population

A

20x higher

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31
Q

Lifetime risk of suicide among people with schizophrenia

A

6%

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32
Q

Increased rate of suicide among people with schizophrenia compared to the general population

A

10x higher

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33
Q

Male:female ratio of completed suicide

A

2-4:1

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34
Q

Most common age for completed suicide in males

A

25-34

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35
Q

Most common age for completed suicide in females

A

15-24

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36
Q

Most common psychiatric diagnoses in completed suicide

A

Depression
Alcohol dependence

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37
Q

Psychiatric diagnoses which do not show an increase in suicide

A

Learning disability
Dementia
OCD - if no concurrent depression

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38
Q

Percentage of completed suicides with a history of DSH

A

40-60%

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39
Q

Percentage of patients with DSH who will repeat within a year

A

30%

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40
Q

Percentage of patients who complete suicide who were in contact with mental health services within a year of their death

A

25%

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41
Q

Percentage of patients who complete suicide who were on a psychiatry outpatient register

A

25%

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42
Q

Percentage of patients who complete suicide who were under the influence of alcohol

A

25%

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43
Q

Percentage of patients who complete suicide who had drank alcohol within 6 hours of their death

A

50%

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44
Q

Percentage of patients who complete suicide who had been seen by a psychiatrist within the previous week

A

12.5%

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45
Q

Percentage of patients who complete suicide who had seen a health worker in the previous 3 weeks

A

33%

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46
Q

Percentage of patients who complete suicide who had seen a GP in the last 4 weeks

A

66%

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47
Q

Percentage of patients who complete suicide who had seen a GP in the last week

A

40%

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48
Q

Most common methods of inpatient suicides

A

Hanging with belts or on curtain rails

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49
Q

Percentage of inpatient suicides occurring in the first week of admission

A

25%

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50
Q

Percentage of inpatient suicides occurring while the patient was on general observations

A

80%

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51
Q

Percentage of patients who complete suicide who were non-compliant with medications

A

20%

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52
Q

Percentage of patients who complete suicide who were within 3 months of discharge from the ward

A

25%

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53
Q

Percentage of patients who complete suicide within 28 days of discharge from hospital

A

0.1-0.2%

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54
Q

Percentage of suicides which are preventable

A

22%

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55
Q

Risk of suicide within 1 year of DSH

A

0.7%

56
Q

Risk of suicide within 1 year of DSH in males

A

1.1%

57
Q

Risk of suicide within 1 year of DSH in females

A

0.5%

58
Q

Increased risk of suicide among people within 1 year of DSH compared to the general population

A

66x higher

59
Q

Percentage of inpatient suicides involving patients on leave

A

33%

60
Q

Percentage of post-discharge suicides which occur before the first check up

A

35-66%

61
Q

Percentage of Black Caribbean patients who completed suicide in England and Wales who had schizophrenia

A

75%

62
Q

Percentage of suicides involving homeless people

A

1-3%

63
Q

Lifetime prevalence of suicidal ideation

A

9.2%

64
Q

Lifetime prevalence of suicidal plans

A

3.1%

65
Q

Lifetime prevalence of suicidal intent

A

2.7%

66
Q

Percentage of people who transition from suicidal ideation to plan and intent who do so in the first year

A

60%

67
Q

Most common method of suicide attempt

A

OD

68
Q

Sex with highest rates of suicide attempts

A

Female

69
Q

Marital status with highest risk of completed suicide

A

Widowed

70
Q

Marital status with lowest risk of completed suicide

A

Married

71
Q

Rate of self harm in the UK per year

A

3 per 1000 per year

72
Q

Percentage of patients with DSH who eventually complete suicide

A

10%

73
Q

Demographic risk factors in the SAD PERSONS score used to assess immediate suicidal risk

A

Sex
Age
Depression
Previous attempt
Ethanol abuse
Rational thinking loss
Social support lacking
Organised plan
No spouse
Sickness (physical)

74
Q

Number of true false statements in the Beck Hopelessness Scale used to assess suicidal risk

A

20

75
Q

Score on the Beck Hopelessness Scale indicating severe suicidal risk

A

15-20

76
Q

Number of items on the Beck Scale for Suicidal Ideation

A

24

77
Q

Maximum score on the Beck Scale for Suicidal Ideation

A

48

78
Q

Maximum score on the Beck Hopelessness Scale

A

20

79
Q

Suicidal ideation in the past year among adolescents

A

15%

80
Q

Medications approved for immediate management of aggression

A

Lorazepam 1-2mg oral/IM
Haloperidol 5mg oral/IM
Olanzapine 5-10mg IM
Promethazine 25-50mg oral

81
Q

Medications used for acute dystonia

A

Procyclidine 5-10mg IM
Benztropine 1-2mg

82
Q

Medication used for decreased respiratory rate following benzodiazepine use

A

Flumazenil

83
Q

First line medication used for catatonia

A

Lorazepam

84
Q

Medications used for NMS

A

Dantrolene 2-3mg/kg
Bromocriptine 2.5-10mg TDS

85
Q

Dose of haloperidol to use for elderly confused/agitation patients

A

0.5mg

86
Q

Percentage of people with epilepsy who complete suicide

A

10%

87
Q

Most common psychiatric diagnosis associated with suicide

A

Depression

88
Q

Country where females have a higher completed suicide rate than males

A

China

89
Q

Percentage of people with a psychotic illness who DSH over their lives

A

25%

90
Q

Phase of bipolar disorder with the highest risk of suicide

A

Depressive phase

91
Q

Percentage of men with bipolar disorder who die by suicide

A

8%

92
Q

Percentage of women with bipolar disorder who die by suicide

A

5%

93
Q

Increased risk in suicide among people who have been hospitalised for bipolar disorder compared to the general population

A

15x higher for men
22x higher for women

94
Q

Suicidal ideation in the past year among adolescent girls

A

22%

95
Q

Suicidal ideation in the past year among adolescent boys

A

8.5%

96
Q

Percentage of patients who have DSH on a given day who will die by completed suicide in the next 24 months

A

1%

97
Q

Percentage of people who die by suicide who have a diagnosable psychiatric disorder at the time of their death

A

90%

98
Q

Affect of passive or active movement on the increased muscle tone seen in catatonia

A

Decreases the tone

99
Q

Most common socioeconomic group for suicide attempts

A

5

100
Q

Decade in which ECT was introduced as a treatment for the first time

A

1930s

101
Q

Risk factors for acute dystonia

A

Young age
Male sex
Recent alcohol or cocaine use
Previous dystonia
Dehydration
Hypocalcaemia
Use of potent antipsychotics

102
Q

Affect of economic recessions on suicide rates

A

Rates increase

103
Q

Affect of wars on suicide rates

A

Rates decrease

104
Q

Affect of media reporting on celebrity suicides on suicide rates

A

Increase transiently

105
Q

Hours after last alcohol intake when DTs usually start

A

48-72 hours later

106
Q

Percentage of patients with dementia who show inappropriate sexual behaviour

A

7-25%

107
Q

Mood disorder with the highest suicide risk

A

Bipolar II

108
Q

Percentage of people with bipolar I who attempt suicide

A

17%

109
Q

Percentage of people with bipolar II who attempt suicide

A

22%

110
Q

Percentage of people with depression who attempt suicide

A

12%

111
Q

Factors which increase suicide risk in a first episode of psychosis

A

More depressive symptoms
Poorer functioning
Longer DUP
Higher awareness of illness
More frequent cannabis use

112
Q

Percentage of patients with a first episode of psychosis who attempt suicide

A

35%

113
Q

Most important risk factor for suicide in a first episode of psychosis

A

Depression during or after

114
Q

Association between antidepressants and early risk of suicide

A

Increased in people aged <25
Neutral in people aged 25-64
Decreased in people aged >64

115
Q

Core features of NMS

A

Exposure to a dopamine antagonist within 72 hours before symptoms started
Hyperthermia
Rigidity

116
Q

Risk of suicide within 2 years of DSH

A

1%

117
Q

Proportion of self harm episodes which occur in people aged >65

A

5%

118
Q

Risk of suicide within 10 years of DSH

A

3%

119
Q

Percentage of patients with DSH who will repeat in their lifetimes

A

40%

120
Q

Percentage of patients with DSH who will repeat at least five times within a year

A

10%

121
Q

Lifetime prevalence of DSH without suicidal intent

A

2%

122
Q

Increased rate of suicide among patients with epilepsy compared to the general population

A

3x higher

123
Q

Annual prevalence of DSH

A

0.5%

124
Q

Lifetime prevalence of DSH

A

6%

125
Q

Percentage of acute presentations of poisoning involving paracetamol

A

30-40%

126
Q

Age group with the highest rate of suicide

A

45-49

127
Q

Most common method of completed suicide

A

Hanging

128
Q

Percentage of 15 year olds in the UK who have ever self harmed

A

22%

129
Q

Average suicide rate in England

A

1 in 10000

130
Q

Average suicide rate in England for mental health service users

A

1 in 1000

131
Q

Percentage of completed suicides which occur in people aged >65

A

20%

132
Q

Condition most associated with murder suicide

A

Depression

133
Q

Most common substance taken in overdose

A

Paracetamol

134
Q

Likely most important factor in the reduction of inpatient suicides over the last 20 years

A

Removal of ligature points

135
Q

Medication that should be combined with IM haloperidol when it is used for rapid tranquilisation

A

IM promethazine

136
Q

Lifetime prevalence of suicide among people with alcohol dependence

A

7%

137
Q

Percentage of patients who present to ED with DSH who visited their GP in the previous month

A

50%

2. General adult psychiatry (9 decks)

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