Suicide Flashcards
Who is at an increased risk for suicidal completion in terms of history, age, substance use, behavior, sex, race, social status, family history, religion, psychotic symptoms, health, occupation, economic conditions, employment?
Serious earlier attempt, older adults, substance abuse/dependence, history of rage/violent behavior, male, white (vs. African-American), socially isolated (vs. married), parent/close relative committed suicide, Jewish/Protestant (vs. Catholic/Muslim), Psychotic Symptoms (vs. none), chronic illness (vs. good health), professional occupation, recession/depression (vs. strong economy), low job satisfaction.
What are modifiable risks? What are circumstantial risks? What are immutable risks?
Modifiable: Substance & Nicotine use, Unstructured time, Perceived stress, Current psychiatric illness, Hopelessness/Helplessness, Anxiety + Panic attacks + Agitation, + Insomnia, Delusion. Circumstantial: Unemployment, Financial difficulties, Relationship difficulties, Physical injury/illness/chronic physical pain, Life transitions, Access to lethal means. Immutable: Patient’s history, FH, Demographics, Cultural/religious beliefs, Personality traits.
List some key symptoms that are precursors to suicidality.
Anxiety + Panic attacks + Agitation + Insomnia + Restlessness. Hopelessness/Helplessness. Hypomania + Mania. Irritability + Hostility + Aggressiveness + Impulsivity.
What are the three points on the risk triad?
Ideation…Intention…Plan
For age, who rarely attempts suicide? When does suicide become a top-5 COD? When does the rate increase? Especially for who? What is the caveat?
Suicide is rare before puberty. 3rd leading COD is adolescents (15-19 y.o.). Increases substantially in adults > 55, especially in elderly men (rate decrease in elderly women). The caveat is that elderly attempt suicide less often, but are more successful.
What gender attempts more suicide? What gender is more successful?
Women attempt 4X as much as men; Men are 3X as successful (use more violent means).
What professions have high rates of suicide? Give possible explanations.
Physicians, dentists, veterinarians (access to drugs), Police officers (access to guns), Musicians & attorneys
Suicide is almost always due to? Especially which? Especially when?
Mental illness – especially depression!! (80% of suicides) Especially with feelings of hopelessness and soon after initiation of an antidepressant or initial stages of recovery (increased energy and clear thinking lead to attempts). Schizophrenia (10%). Physical health (about 1/3 of those who commit have sought medical attention w/in last 6 months…many have seen PCP w/in last month).
How should treat with a suicidal patient proceed?
Interview about the triad (ideation, intents, plans) & take a good history of risk factors and protective factors. Use the least restrictive approach.
