Self-harm and suicide Flashcards
1
Q
What are the important questions to ask in a suicide history?
A
Made a plan? Thoughts of suicide? Put affairs in order? Write a note? Method? Did you think that would kill you? Any actions to make sure you weren't found? Tried to do this before? Sought help? Why? Why that method? Overdose - what? How much? How long ago? Recent events that may have triggered this? Alcohol/drug? Regret? Planned? Impulsive? Intoxicated? Medication compliance? Support networks? Speak to people around for a collateral history
2
Q
What questions should you ask in a self harm history?
A
Thoughts? Plan? Method? Why? How often? Sought help? Alcohol or drug usage? Regret? Planned? Impulsive? Intoxicated? Medication compliance? Support networks? Speak to people around them for collateral history
3
Q
What are the risk factors for suicide?
A
Male Older Living alone Immigrant status Recent bereavement, separation, divorce Unemployment or retirement Living in socially disorganised area Family or personal history of affective disorder, suicide, alcohol, or drug misuse Addiction to alcohol or drugs Severe depression or early dementia Incapacitating painful physical illness
4
Q
How common is suicide?
A
2% male and 1% female deaths in England and Wales each year
8 per 100,000o
Rate increased with age peaking for women in 60s and men in 70s
Suicide 2nd most common cause of mortality in 15 to 34
Lifetime risk 7% in alcohol dependence, 6% in affective disorders, and 4% in schizophrenia
Highest rates in rural Southern India and Eastern Europe
Lowest rates in Spain and Greece
5
Q
What investigations should you do in an overdose?
A
Bloods - LFTs, U&Es, FBC, ESR/CRP ECG Urine sample - drug testing Vital signs Breathalyser MSE
6
Q
How do you manage suicide or self harm?
A
Referral to psychiatrist Indications for referral: Absolute - Clinical depression - Psychotic illness of any kind - Clearly planned suicidal attempt that was not intended to be discovered - Persistent suicidal intent - Violent method used Other - Alcohol and drug misuse - Patients over 45 - Family history of suicide - Serious physical disease - Living along or otherwise unsupported - Major unresolved crisis - Persistent suicide attempts - Any who give you cause for concern
7
Q
What conditions can involve self harm or suicide?
A
Eating disorders EUPD/other personality disorders Depression Bipolar disorder Alcohol and drug misuse Psychosis ADHD Autism
8
Q
What are the risks of overdosing?
A
Death Respiratory depression leading to death/brain damage Dehydration from vomiting Seizures Heart rhythm abnormalities Permanent brain damage Interactions with other medications Risk of neglect Generally vulnerable Risk to themselves from self-neglect - eating? Sleeping? Liver function damage due to overdose
