suicide Flashcards
Canadian completed suicide rate
Number
11.5/100,000 3,000 per yr Teens make up 5% of that only suicide ratein elderly is 63/100,000 = 0.55 per 100,000 (this is from London, but american suicide GL in peds gives higher numbers 1-15 per100, 000 divided by age)
percentage of adolescents that attempt
3%
Ks say 2-6%
gender ration for completion and attempts
females 4 times more likely to attempt
males 4 times more likely to complete
aboriginal youth are…..X more likely?
6 times
sensitivity of predicting suicide
55%
we can’t predict. w can assess
time lapsed and lethality of past attempts predict what % of suicide completion
20% of those who used highly lethal methods completed suicide ayer
20% of attempters complete suite with in 1 month.
risk of suicide for affective DO
schiz
SUD
BPD
15% (50-70% of suicides)
10%
3%(but associated with around 50% of all suicides)
those DO and PD are most associated with suicide
10% (9-33% of suicides)
Peak numbers
45-49
Over 85% of suicides over age 25
Teen 5% of all suicides
Self harm rate?
Risk of suicide?
140/100,000
1% per yr go in to suicide completion
25% of suicides had self harm in past ur
Highest RR of completing suicide after attempt ( by type)
CO poisoning RR 5
Most important RF for suicide in general?
In depressed?
Previous self harm
RR 100
RR 5
Serotonin in suicide
Reduced activity Fewer transporter sites in VLPC Decreased tryptophan hydroxyl add Decreased 5HIAA in CSF Increases 5ht2a in platelets
Prevention
Best evidence: Training 1ry physicians ant dep Then reduce access to means Focus on high risk group Media?
suicide in schiz
DSM V 104: suicide risk: 5-6% die, 20% attempt
RF: young, male, comorbid Substance , depressive sx, hopelessness, unemployment, post psychotic episode or D/C from hospital.
Guidelines: depression, 6 years post 1st admission, high IQ, higher premorbid achievement and aspirations, awareness of loss of functioning,
Also: command AH, recent DC from hospital, nonadherence, akathesia
wierd: active psychotic sx not associated with increased risk (London)
how do preveous attemtpts inform risk
risk increases with number of attempts
lethality of attempts is more predictive than number
20% of suicdes are commited a onth after an attempt
those with lethal attempts: 20% killed themselves withing 5 yrs
