Risk Flashcards

1
Q

Can risk be eliminated?

A

No

It can be assessed, managed, frequently reviewed.

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2
Q

What is suicide?

A

A fatal act of self injury, undertaken with more or less conscious self destructive internet, however vague and ambiguous.

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3
Q

What is para-suicide?

A

Similar to suicide, but for whatever reason the victim survived the attempt

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4
Q

Describe deliberate self harm

A

An act of self harm where the action was not with the intention of death, but to cause harm

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5
Q

Roughly how many people commit suicide wordwide each year?

A

1 million

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6
Q

What is the usual male to female suicide ratio?

A

3:1

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7
Q

In 2017, what age group for males had the highest rates of suicide?

A

45-49

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8
Q

In 2017 what age range for females had the highest suicide rates?

A

50 to 54

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9
Q

When is suicide risk at its highest?

A

During inpatient stay and 14 days post discharge

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10
Q

What are some suicide risk factors?

A
Male
Living alone
Unemployment 
Drug and alcohol misuse 
Mental illness
Past self harm
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11
Q

What are the main correlates between mood disorders and suicide?

A
Greater severity of illness 
Self neglect
Hopelessness
Alcohol abuse 
Impaired concentration 
History of suicide behaviour
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12
Q

How many times are people with bipolar disorder more likely to attempt suicide than the general population?

A

20 times

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13
Q

What are the main correlates between schizophrenia and suicide?

A
Positive psychotic symptoms 
Post psychotic depression 
Young and male 
First decade of illness
Relapsing pattern of illness
Recent hospital discharge 
Social isolation 
Good insight into illness
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14
Q

What are the main correlates between alcohol abuse and suicide?

A
Male sex
Longer duration of problems 
Single/divorced/widowed
Multiple substance abuse
Comorbid depression
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15
Q

What are the main correlates between PD and suicide?

A

Depressive syndrome or substance (alcohol) abuse

Borderline PD at highest risk - accidental deaths

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16
Q

What are the main correlates between chronic physical illness and suicide?

A

Severe chronic pain
Disfigurement - especially in women
Loss of job, role, family, money

Increased risk with chronic neuro, GI, cardio, cancers

17
Q

What are the two main types of deliberate self harm?

A

Self poisoning

Self injury

18
Q

Are the highest rates of deliberate self harm in males or females?

A

Females

19
Q

What is the peak age range for deliberate self harm?

A

15-44

20
Q

What is the percentage of increased suicide risk in people with h/o DSH?

A

40-60%

21
Q

What methods are there for DSH?

A

Cutting, burning, scratching, banging, wound healing interference, hair pulling, toxin ingestion

22
Q

What are some associations with repeated self harm?

A
Alcohol/ drug misuse 
Unemployment 
History of trauma- sexual or physical abuse 
Criminal record 
Single/divorced
FH - 4 times increased risk
23
Q

What are some possible motives underlying DSH?

A
Wish to die
Cry for help
Communication with others
Unbearable symptoms 
Temporary relief of anxiety
24
Q

What are some psychological characteristics associated with DSH?

A

Impulsivity
Cognitive rigidity
Problem solving deficits
Hopelessness

25
Q

What percentage of substance abuse is done at the time of or before DSH?

A

Male: 40-70%
Female: 12-50%

26
Q

When taking a history for DSH what questions should be included?

A

Triggers
Preparation - planning in advance, final acts
Circumstances - alone, precautions against discovery, alcohol, what did they think would happen and what did they want to happen?
After the act - regret failure, did they seek help?

27
Q

In psychotic disorders, what factors can increase homicide risk?

A

Specific persecutory delusions or hallucinations

Command auditory hallucinations