Psychiatric Emergencies Flashcards
1
Q
Suicidal etiology
A
- sociological, psychological, physiological
- genetics: suicide runs in families
- Neurochemistry: pts who attempt suicide have lower 5-HIAA level in CSF
2
Q
Associations in Suicide
A
- up to 90% who commit suicide have at least one major psychiatric disorder
- MDD. Bipolar, Schizophrenia, substance abuse, anxiety, Personality disorder (borderline or antisocial)
3
Q
Suicide Risk Factors
A
- Age: adolescent and elderly: > 60 (less attempts, more successful)
- Male: men commit 4x more than women (women attempt 4x more)
- Single, widowed, separated/divorced : 4x more likely
- Presence of psych d/o: MDD, bipolar, schizo, dementia/delerium
- Presence of substance abuse
- Caucasian
- feelings of hopelessness, helplessness, Isolation, Chronic illness
4
Q
Ways men commit suicide
A
- firearms
- hanging
- jumping
5
Q
Ways women commit suicide
A
- overdose of meds
- poison
6
Q
parasuicidal behavior =
A
injure themselves by self mutilation but do not wish to die
7
Q
Risk factors for previous suicide attempt
A
- family h/o completed or attempted suicide
- recent psych hospitalization: within 3 mnths
- recent loss: job or rltnshp
8
Q
High Risk characteristics
A
> 45 y/o male alcohol dependence violent behavior previous suicidal behavior previous psych hospitalization
9
Q
Suicidal pts: when to hospitalize
A
- the absence of strong social support system, h/o impulsive behavior and a suicidal plan of action are all indications for hospitalization
- If pt cannot agree to call when reaching the point of uncertainty about their inability to control suicidal impulses should be hospitalized
10
Q
Tx for suicidal pts:
A
- tx underlying cndtns: antidepressants/antipsychotics
- supportive therapy
- dissuade pts from making life decisions while suicidally depressed
11
Q
Baker Acted
A
- situation in which an individual can be hospitalized against their will
- done if the pt is in serious danger to self or others, or if they are likely to suffer from neglect or harm if current behavior continues
12
Q
Dystonia =
A
-brief or prolonged contractions of muscles that result in abnormal mvmnts/postures, tongue protrusion, truisms, torticolis, laryngeal/pharyngeal dystonia, dystonia of libs/trunk
13
Q
Causes of dystonia
A
- potential side effect of antipysch meds
- usually occurs in first 4 days of tx or following an increase in dose
- less likely to occur in those on the newer antipysch drugs
14
Q
Meds that tx dystonia
A
- Benztropine (Cogentin)
- Diphenhydramine (Benadryl)
- Benzos (Valium or Ativan)
15
Q
Neuroleptic Malignant syndrome =
A
-life threatening complication of anti psych tx and can occur anytime during the course of tx
