Suicide Flashcards
Does talking about suicide increase feelings of depression and potentiate suicidal behavior?
No- there is a sense of relief for the empathy and caring
Is it true that only low-functioning or crazy people attempt suicide?
No
Is there a relationship between media coverage of high profile suicides and rates of suicidal behavior in the US?
YES! - esp in the month following the celebrity death
What season/month has the highest suicide rate in the US?
April
What are 2 potential explanations for increased risk of suicide-related deaths among physicians?
- potential barriers to adequate mental health care because of professional attitudes that discourage admission
- physicians are more likely to have a job-related stressor compare to non-physicians
Define suicide attempt vs. suicide.
Suicide attempt = self-inflicted, potentially injurious behavior with a non-fatal outcome where there was evidence the person wanted to die [explicit or implicit]
Suicide = fatality
What is suicidal ideation?
Thoughts of causing one’s own death that can exist on a spectrum of:
- specificity
- frequency
- intensity
- intent
What is suicidal intent?
Death is the intended result of one’s actions.
It does NOT include medical lethality [taking a bunch of meds that can’t kill you]
What is non-suicidal self-directed violence?
Self-inflicted personal injury where the intent is not to kill himself/herself, but rather to garner attention
What is the relationship between gender and suicide?
Women are more likely to attempt suicide but men are 4x more likely to complete suicide
What are high risk groups for suicide?
- lesbian, gay, bisexual youth
- returning veterans [although freq has decreased]
- old, lonely white men
What race/ethnicity is most likely to commit suicide?
Caucasians are greater than 90% of suicides in the country
US American Indians and Alaskans have the highest suicide rates [but because their total population is small, whites still have the highest frequency]
What acute risk factors increase the chances of intentional self-harm in a suicidal person?
- current ideation, intent, plan, access to means
- recent suicide attempt
- recent self-harm behavior
- hopelessness- presence, duration, severity
- recent discharge from an inpatient psychiatric unit
- increased alcohol/substance abuse
- impulsivity and poor self control
- intense psychological pain
What 3 factors decrease the risk of intentional self harm in a suicidal person?
- positive social support
- spirituality- religious beliefs prohibit it
- children at home/pregnancy
- responsibility to family
- life satisfaction
- intact reality testing [no psychosis, paranoia, delusion]
- positive coping skills
What 5 patient groups should be screened routinely for for suicide risk?
- symptoms of depression or mania
- ask about suicide risk - history of mental illness
- warning signs
- active-duty military returned from combat
- released recently from psychiatric facility
When should a patient be referred for outpatient evaluation by a mental health care provider?
- hopeless
- rage, anger, revenge seeking
- reckless/risky behavior
- increased alcohol/drugs
- withdraw from friends, family, coworkers
- anxious, agitated, insomnia or excessive sleep
- changes in mood
- unable to articulate reason for living
When is a patient determined to be at imminent risk for suicide?
What immediate action should be taken?
- verbal threats to hurt or kill themselves
- looking for ways to kill themselves
- access to weapons, pills, etc - preoccupied with death, dying, suicide
Action Steps:
- do not leave the person alone [1:1 monitoring]
- request psychiatric eval
- involve family/friends [SAFETY> confidentiality]
- limit access to means of suicide [have family clear out their residence of weapons, pills etc]
What 2 actions are crucial when responding to a suicidal crisis?
- assure the patient’s immediate safety
- 1:1, psychiatric eval, involve family, limit access to means - Determine appropriate treatment setting
- call police to escort patient to emergency psych eval
- Refer patient for psych eval and assure followup is made
- increase contact and commit to help through the crisis
How does age affect suicide?
Increased # under 30 attempt suicide
Increased # over 45 complete suicide
Rate of suicide for adults over 75 is higher than general population
What is the effect of psychiatric illness on suicide?
90% of suicide victims have a psychiatric disorder
- bipolar
- schizophrenia
- borderline personality disorder, MDD
- depression
- alcohol/drug abuse
What is the correlation btw antidepressant use and suicide?
Black box warning that medication increases suicide ideation and behavior in children, adolescents and young adults but not 24-65 age group
What are the perpetuating risk factors for suicide that are permanent and non-modifiable?
- age and gender
- history of attempts
- prior ideation
- history of self-directed violence
- trauma/abuse
- psychiatric hospitalization
- separation, divorce, marital conflict
What are Major Axis I psychiatric disorders?
- mood disorders
- schizophrenia
- anxiety disorders
- substance use disorders
- body dysmorphic disorder
What are the Axis II personality disorders?
Cluster B - borderline personality, antisocial, narcissistic, histrionic
What 3 illnesses have increased suicide risk?
- HIV/AIDS
- cancer of lung head, neck
- MS
What medical conditions are associated with an “unclear” risk of suicide?
- Parkinson’s
2. spinal cord injuries
What medical condition has a decreased risk of suicide?
pregnancy
