Suicidal Behavior

Question 1

interrupted suicide attempt

Answer 1

person is stopped by another person

Question 2

aborted suicide attempt

Answer 2

person is stopped by self

Question 3

suicide attempt

Answer 3

potentially self-injurious act committed with at least some wish to die as a result of act

Question 4

preparatory suicidal behavior

Answer 4

anything beyond verbalization or thought; includes assembling a method, writing a note

Question 5

epidemiology

Answer 5

1 million suicides/year worldwide; 10-20x more attempts; 3rd leading cause of death in 10-34 y/o in the US

Question 6

risk factors

Answer 6

previous suicide attempt, family history of suicide attempt, current ideation, worst lifetime ideation

Question 7

stress-diathesis model of suicide

Answer 7

stressor- untreated psychiatric illness (60%- MDE) or social crisis in context of psychiatric illness –> suicidal ideation
stressor + diathesis –> suicidal act
impulsive/aggressive traits, severe depression and hopelessness, earlier onset depressive illness, previous personal or family history of suicide attempt

Question 8

prevention

Answer 8

recognition of psychiatric illnesses associated with suicidal behavior, recognition of higher risk patient with predisposition

Question 9

treatment

Answer 9

treatment of psychiatric illness, resolution of crisis, reduction of predisposition, means restriction (gun control), supervise the patient during acute suicide risk period

Question 10

neurobiology

Answer 10

low norepinephrine and low serotonin
NE depletion –> hopelessness/pessimism
low serotonin –> impulsivity
HPA axis activation –> excessive cortisol
decreased glucocorticoid receptor feedback system