Suicide Flashcards
Suicide Rate
30,000/yr Attempted: 300,000/yr
Suicide is the _____leading cause of death
9th
Suicide Associated factors
age (65+ or 14-24 increased rapidly) Never married, divorced Males> Females (3X) Females attempt > males (4X)
Race and suicide
American Indian and White males
Location and suicide
Western states
Domains of Suicide risk
Social: loss or life change Psychological: personality or coping Medical: illness, treatment Psychiatric: depression Biological aging, environment
Suicide Global Rates
Highest in Korea
Military And Suicide
Escalating since beginning of War (Army)
Suicide rate timeline
Suicides dropping from 1990-2003, in 2003 1-14y/o rate of suicide markedly increased (hanging and suffocation)
Suicide Major Risks
Depression (20X), Substance Abuse (alcohol, heroin), Physical health (age, illness, immobile, etc)
Suicide Risks
Unemployed, Separated (divorce, death), Irritable, social disgrace, death trends, personality (impulse, perfectionist), Risk taker, Failed treatment, existential crisis
_____% of attempted suicide patients fir criteria for mental illness
80
Suicide Risk Factors
Poor Health, Psychoactive drugs, hopelessness, self doubt, adverse life events, marginalization
Suicide Protective Factors
Mental Healthcare, Safe and supportive environment, health relationships, ability to cope, problem solve and find meaning
Mental Disorders highly correlated to suicide
Mood Disorders (15%) panic attacks, psychic Panic Disorder (15%): attack severity, agitation Schizophrenia (10%) Borderline PD (7%) impulse, anitsocial, self-mutilation
Most people contacted __________prior to committing suicide
medical provider
Medical Population and suicide
Depression, traumatic news, risky behavior, hopelessness, noncompliance
Which Illnesses are linked to suicide the most
Dialysis patients (14%), Head and Neck Malignancies(11%), HIV, Lupus, Spinal cord injury
Suicide Causes
Sociological disruption, Struggle with Aggression, Manipulation, Identity Problems, Hopelessness
Indicator of long term risk of suicide
hopelessness
Rational Suicide
taking one’s life due to extreme illness
Suicide Assessment
Suicide Ideation/Recent events, Ambivalence, Previous Attempts, Plan, Affect (hopeless, calmness, euphoria, psychomotor retardation)
Primary Care Suicide Assessment
Diagnosis overwhelms coping, have family member present, follow-up in 24hr, sensitive to cultural factors
3 Identifiers for Suicide Assessment
Previous Attempts, Depression OR Substance Abuse, 1st degree relative suicide
Plan in Primary Care
Screen for depression, anxiety, psychosis, substance abuse, Ask about suicidal thoughts, plans, screen for medical conditions associated, cognitive changes, ask about previous attempts
Tips for Suicidal patients
Suicide intent is “state dependent”, suicide state repeats, turn focus to causes, have family monitor risks
Imminent risk factors for suicide
Severe agitation, panic, obsessive rumination (bad thoughts), global insomnia, alcohol use, isolation, anhedonia, isolation, deception, publicity of suicide, incarcerated
Suicide Treatment
Hospitalization, antidepressants, antipsychotics, therapy Systems Approach, remove means, commitment of patient Reduce psychological pain
Tips for suicide prevention
Realistic approach to problems, emphasize past successes, patient’s perception is distorted, mobilize support system, be objective, non-judgmental
Tips for suicide prevention
Other solutions, acknowledge patient’s feelings, use social services, programs, “I’m going to help”
Spousal-Amorous Jealousy Suicide Type
chaotic relationships, infidelity real or imagines, separation from perpetrator
Spousal-Declining Health Suicide Type
Dependency of spouse, financial concerns, frustration, helplessness, “mercy” killing
Filicide Suicide
Parent killing own child 0-6mo highest risk, then commit suicide
Familicide Suicide
When 1 spouse and at least 1 child is murdered, then commit suicide
Extrafamilial Suicide
Killing relatives before self
Murder-Suicide Characteristics
over-valued attachement to relationship, fear of separation, impulsiveness, mental disorder present (mood, psychosis, substance abuse), stalking
Murder-Suicide Assessment
Assess for homicidal tendencies, depression, feeling overwhelmed, over-possessive, Female>Male
Murder-Suicide Intervention
diffuse relationship, restore perspective, case management help, help survivors
Red Flags for Murder-Suicide
Domestic violence, jealous, declining health, financial problems, depression, over-possessive, desperation, “altruistic ideation”
Tips for Murder-Suicide
Assess risk of violence, treat underlying mental health, find social support
Risk Factors for Adolescent Suicide
Hypersensitive, suggestibility, magical thinking, fanaticism, rigid thinking, dichotomous thinking
Process of Adolescent Suicide
Long Standing History (family dysfunction), escalation of problems (conduct, rebellion, withdrawn), affiliation phase
Adolescent Suicide Trends
Increase due to social media in adolescents, militants due to war, general pop due to untreated depression bc of anti-depression warnings
Adolescent Suicide Rates
12% of adolescent deaths, hanging>CO)
Suicide in children
-Vulnerability: parental mental health disorder, FHx - Childhood disorders or abuse - Following stress, followed by immature coping and impulsivity - Fewer precipitating events in combination with family/school transition
Risk Factors for
Precipitation Factors (parents mental health, FHx of suicide, genetics) compounded by family factors, school factors, cognitive immaturity, adverse life events, age-related impulsivity, access to suicide means, psychopathology
Initial Suicide Attempt
First attempt before high school, early first attempt linked to depression, high at age 12 increases to peak at age 15
Greatest risk factors for suicide
Direct verbal warnings, plan (specific, lethality, availability), past attempts, depression, hopelessness, indirect statements, intoxication, gender
Treating Suicidality
If imminent, admit patient, if not contact lifeline, treat underlying disorders or addictions, assess stressors, risk factors
Beck Depression Inventory
Sadness, pessimism, dissatisfaction, guilt, somatic problems, self dislike, etc
