Suicide

Question 1

What are the 4 biggest risk factors for a patient to commit suicide in the near future?

Answer 1

anxiety, panic attacks, agitation and insomnia

Question 2

What are the 3 corners of the risk triad?

Answer 2

ideation, intention and plan

Question 3

What is the risk triad?

Answer 3

Identifies the level of risk of a patient committing suicide (low, medium, high)

Question 4

What type of health problem is almost always the cause of suicide?

Answer 4

mental illness (particularly depression)

Question 5

In which age group is suicide the 3rd leading cause of death?

Answer 5

adolescents (15-19

Question 6

At what age in adulthood does the risk of suicide increase substantially?

Answer 6

after 55

Question 7

What is the trend in suicide risk for the elderly in males vs females?

Answer 7

decreased risk for females, increased risk for males

Question 8

Do elderly people tend to attempt suicide more or less often than younger people?

Answer 8

less often, but are generally more succcessful

Question 9

Do females attempt suicide more or less often than males?

Answer 9

more often (4x as much), but males are 3x more likely to succeed than females because they tend to use more violent means

Question 10

Which ethnicity has lower suicide rates; african americans or white americans?

Answer 10

african americans

Question 11

Do immigrants usually have a higher or lower rate of suicide?

Answer 11

higher-both here and in their native countries

Question 12

How does marital status effect suicide rates?

Answer 12

• lower rates if married and also if children are in home

- higher if separated, divorced or widowed

Question 13

Are divorced men or divorced women more likely to commit suicide?

Answer 13

divorced men

Question 14

What is an anniversary suicide?

Answer 14

person commits suicide on the day a family member did (can also be on anniversaries of marriages/divorces etc..)

Question 15

In which religions are suicide rates lower and why?

Answer 15

catholic and islamic-because the religion prohibit suicide

Question 16

Is suicide higher in employed professionals or employed non-professionals?

Answer 16

employed professionals

Question 17

Which professionals have even higher risks of suicide and why?

Answer 17

physicians, veterinarians, dentists-access to Rx

police officers-access to guns

Question 18

In unemployed vs employed which has a higher risk of suicide?

Answer 18

unemployed

Question 19

Which specialties in medicine have the highest risk of suicide?

Answer 19

1) Psychiatry
2) Ophthalmologists
3) Anesthesiologists
* *higher in women than men also**

Question 20

What else do physicians who commit suicide usually have going on and how does it usually occur?

Answer 20

• usually have mental disorder (depression and/or substance abuse)
• usually by substance overdose

Question 21

Which of the following put a patient at increased risk for suicide: substance abuse, aggressive and impulsive behavior, Family history of suicide, peer history, december/holiday periods

Answer 21

All put the patient at increased risk of suicide except december/holiday periods; spring and fall actually have increased rates of suicide

Question 22

Which 2 mental illnesses account for most suicides?

Answer 22

depression and schizophrenia

Question 23

Which gene polymorphism conveys poor resilience, putting the patient at an increased risk for suicide?

Answer 23

SERT gene-ss genotype

-codes for the serotonin receptor

Question 24

What is a victim precipitated homicide?

Answer 24

using others (usually police) to kill oneself (ex: police killing person in self defense because they are threatening to kill the police)

Question 25

Aside from killing an unwilling person, how else can a murder suicide occur?

Answer 25

as a pact (but also sometimes the pact can be by coercion)

Question 26

How is suicide treated/prevented?

Answer 26

• interview focusing on the triad
• get a good history about risk factors
• ask about things that are keeping them alive (protective-ex:pets)
• use the least restriction possible without putting the patient or others at risk

Question 27

What would be the least restrictive approach?

Answer 27

1) add medication to quickly address anxiety, depression etc
2) add slower acting antidepressants, psychotherapy and increase social support
3) If all else fails, send them to hospital

Question 28

If a patient is at a high risk for suicide and is unwilling to be admitted to the hospital, how long can they be committed for against their will?

Answer 28

1-63 days (any longer requires court involvement)

Question 29

Can medications be forced once the patient is committed?

Answer 29

NO

Question 30

Who is legally responsible if the patient is not recognized as suicidal during a visit or if a prescribed medication is used in suicide?

Answer 30

the physician