Seminar 9

Question 1

Suicide

Answer 1

Suicide is an action of killing oneself intentionally.

Question 2

Prevalence

Answer 2

1.000.000 suicides/ year in the world
150.000 suicide/year in Europe
10-20 x more attempts

Question 3

Main methods used by lethal suicides

Answer 3

Self-strangulation 
Self-poisoning
Jumping from a high place
Jumping or lying before moving object
Handgun
Sharp object 
Drowning

Question 4

A, Primary, psychiatric risk factors

Answer 4

Psychiatric disorder (90%): 
major depression (45-87%)
schizofrenia
substance dependence and/or abuse
personality disorder
Anxiety disorders

Question 5

B, Secondary, psychosocial risk factors:

Answer 5

Childhood trauma / losses
Agression, impulsivity 
Isolation,
Negative life events
Smoking

Question 6

C, Tertiary, demografic risk factors:

Answer 6

Male gender, homosexuality 
Adolesence, midlife and older age (65+)
Vulnerable periods:
Spring and early summer, 
Birthday, 
Perimenstrual period,
Morning hours
Mondays

Question 7

Protective factors

Answer 7

Good family/social/medical support
Children
Pregnancy
Religiosity
Lack of lethal means
Regular physical activity
Hipersomnia

Question 8

Crisis

Answer 8

Overhelming situation (can not be avoided)

Question 9

Cry for help

Answer 9

Warning sign in almost all cases.
Communication of suicide intent
Indirect signs - risk taking behaviour

Question 10

Presuicidal syndrome - Ringel

Answer 10

Inhibited aggression directed towards the self

Suicidal thoughts, intense phantasies about one’s death, funeral

Ambivalence!

Question 11

active suicide

Answer 11

individual takes concrete actions

Question 12

passive suicide

Answer 12

refuse those actions that would be necessary for living

Question 13

suicide ambivalent

Answer 13

the intention of suicide is not obvious

Question 14

Types of suicide attemtps

Answer 14

1, Deliberate self-harm – relaese psychological pain

2, Parasuicide pause/ temporary rest

3, Parasuicide gesture (manipulation)

4, Serious suicide attempt (intent to die)

Question 15

Wherter effect

Answer 15

Striking increase in railway suicides after the suicide of German goalkeeper Robert Enke in 2009.

Question 16

Youth suicide

Answer 16

15-24 and 25-34 leading cause of death in Hungary

Question 17

Warning Signs for Youth Suicide

Answer 17

Sense of being a burden
Profound sense of loneliness, alienation and isolation
Sense of fearlessness

Question 18

„To do list”

Answer 18

Supportive
Keep distance
Clarify
Refer to adequate therapy

Question 19

Crisis intervention

Answer 19

Try to widen the patient’s view (problem –focused, fixed)

Question 20

Intervention

Answer 20

Three basic steps:

	1. Show you care
	2. Ask about suicide
	3. Get help

Question 21

Myth vs. Fact

Answer 21

Myth: People who talk about suicide don’t die by suicide.
Fact: Many people who die by suicide have given definite warnings to family and friends of their intentions. Always take any comment about suicide seriously.

Myth: Suicide happens without warning.
Fact: Most suicidal people give many clues and warning signs regarding their suicidal intention.

Question 22

Ten Most Common Errors During A Suicide Intervention

Answer 22

#1: Superficial Reassurance
#2:  Avoidance of Strong Feelings
#3: Professionalism
#4: Inadequate Assessment of Suicidal Intent
#5: Failure to Identify the Precipitating Event
#6: Passivity
#7: Insufficient Directness
#8: Advice Giving
#9: Stereotypic Response
#10: Defensiveness