Self-harm Flashcards
What are the risk factors that increase the risk of suicide?
Male
Older age
Living alone
Immigrant status
Recent bereavement, separation or divorce
Unemployment or retirement
History of affective disorder, alcohol or drug misuse
Family history of affective disorder, alcohol or drug misuse
Previous suicide attempt
Addiction to alcohol or drugs
Severe depression or dementia
Incapacitating painful physical illness
Which group does majority of self harm occur in?
Under 35yrs
Self harm is more common in women whilst suicide is more common in men
What is the trend of suicide?
Suicide is falling in women
Suicide is increasing in young men
Suicide is most common in older men but is declining
Majority of suicide occur in aged over 60
What factors are cause for concern in a patient who harms themselves?
Clear precipitant / cause for attempt
Suicide note?
Patient doesn’t want to be discovered
Patient would do it again
Other relevant factors:
Has the precipitant / cause resolved
Was the act premeditated or impulse?
Continual suicidal intent?
Any psychiatric symptoms?
What is patient’s support system like?
Have they self harmed before
Anyone in their family ever taken their lives
Debilitating physical illness
What are the indications for referral to a psychiatrist?
Absolute indications:
=> Clinical depression
=> Psychotic illness of any kind
=> Pre-planned suicidal attempt - not attempted to be discovered
=> Violent method used
Common indications:
=> Alcohol and drug misuse
=> >45yrs especially if male or young adolescent
=> FHx of suicide in first degree relative
=> Serious, incurable disease
=> Living alone and unsupported
=> Persistent side attempts
=> Any patient who is a cause for concern
Risk of suicide is higher in those with a history of self-harm
Important to gauge the situation by speaking to a family member or a close friend.
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