Psychiatry - Suicide

Question 1

Suicide?

Answer 1

• Fatal act of self-harm initiated with the intention of ending one’s own life.
• Although often seen as impulsive, it may be associated with years of suicidal behaviour including suicidal ideation or acts of deliberate self-harm

Question 2

Suicide?

Epidemiology?

Answer 2

• 2012: 5,981 suicides in the UK in people over the age of 15
• Male suicides are three times as common
• The highest suicide rate is in men aged 40-44
• Suicide rates in 2012 in the UK were higher than five years before, but lower than 20 years before. Suicides in the under-25 age group have significantly reduced in the last 20 years
• The most common methods of suicide are hanging, strangulation and suffocation, followed by poisoning
• 50% of people who take their own lives have previously attempted to harm themselves

Question 3

Suicide?

Aetiology?

Answer 3

Risk factors for suicide:

• Previous suicide attempt or previous self-harm
• Male gender (three times more likely than women)
• Age (currently highest in the age group 40-44 years)
• Concurrent mental disorders or previous psychiatric treatment
• Unemployment
• Homelessness
• Alcohol and drug abuse
• Physically disabling or painful illness, including chronic pain
• Low socio-economic status, loss of a job
• Certain professions - this has changed in recent years
• Low social support/living alone
• Significant life events - bereavement, family breakdown
• Institutionalised e.g. prisons, army
• Bullying (sometimes a factor in children and adolescents where social media and/or pro-suicide websites play a part)

Question 4

Suicide?

Assessment & Management?

Answer 4

• Through Hx taking – psychiatric Hx which will include risk factors, intent of plans, current risk, assess needs
• Care plans
• Medication, counselling, CBT, DBT
• High risk patient – compulsory hospitalisation