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Psychiatry pro +1700 > Suicide > Flashcards

Suicide Flashcards

1
Q

For every suicide, how many attempted suicides are there?

A

11

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2
Q

What is a crisis?

A

The point in an individual’s life situation, when urgent intervention is required to avoid precipitous deterioration of his/her condition

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3
Q

What is the most common source of error in the ED with psychiatric concerns?

A

Overlooking physical conditions as an underlying cause of emotional distress

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4
Q

True or false: psychiatric dx usually stay on a patient’s chart, even after the true etiology is later confirmed

A

True

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5
Q

What is the usual resulting behavior in a provider, when they are afraid of a patient? What are the consequences of this?

A
  • More restrictive measures than necessary

- Start action to regain autonomy

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6
Q

What is the usual resulting behavior in a provider, when they over identify with the patient? What are the consequences of this?

A

Relaxing of precautions and lack of appropriate response

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7
Q

What is the usual resulting behavior in a provider, when they are angry at a patient? What are the consequences of this?

A
  • Over-react and control/punish

- Fear in the patient and decreased self closure

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8
Q

What is the usual resulting behavior in a provider, when they are feel any measures they provide for a patient are hopeless? What are the consequences of this?

A
  • passive or slow to intervene

- Lack of appropriate response, pt feels more hopeless

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9
Q

What are the common chronic medical condition that usually cause thoughts of suicide?

A
  • AIDS
  • TBI
  • CA
  • Epilepsy/Huntington’s
  • Spinal cord injuries
  • Cardiopulmonary disease
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10
Q

What are the three major reasons for suicidal ideation from the internal mental state?

A
  • Feelings of absolute guilt
  • Need to escape
  • Intolerable emotional states
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11
Q

True or false: psychotic patients are more likely to be violent than non-psychotic patients

A

True

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12
Q

True or false: psychotic patients are more likely to be victims of violence, than be perpetrators

A

True

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13
Q

What types of psychotic disorders are more likely to lead to violence?

A
  • Paranoia

- Command hallucinations

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14
Q

What type of hallucinations are more likely to lead to violence?

A

Command hallucinations

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15
Q

Which two PDs are particularly prone to violence?

A

Borderline PD

Antisocial PD

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16
Q

What two lobes of the brain that, if injured, lead to violence?

A

frontal and temporal lobe

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17
Q

Is childhood or adolescent aggression more concerning for future violent behavior?

A

Childhood

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18
Q

True or false: a h/o having been victimized leads to a lower incidence of violence in the future

A

False–risk factor for violence

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19
Q

Are males or females a risk factor for violent behavior?

A

Male

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20
Q

What is the triad of symptoms that predicts violent behavior in kids?

A
  • Firesetting
  • Cruelty to animals
  • enuresis
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21
Q

Is a younger or older age a risk factor for violent behavior?

A

Younger

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22
Q

What are the three major questions to ask to assess for violent behavior?

A
  • Thoughts of harming others
  • h/o seriously injuring another
  • Most violent act ever committed
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23
Q

What are the four major steps to take when talking to a potentially violent patient?

A
  1. Multiple communications
  2. Alert staff
  3. Watch for physical signs and indicators
  4. Have all emergency info in place
24
Q

Should you avoid direct eye contact with violent patients?

A

Yes

25
Q

What should be the character of your voice with violent patients?

A

Remain calm and speak quietly

26
Q

Where should you be relative to the patient and the door?

A

Closer to the door, but not blocking it

27
Q

How far should you stand away from a violent patient?

A

Leg length

28
Q

True or false: it is best to hospitalize all “at risk” patients, in terms of suicide potential

A

False

29
Q

What is the only reason to psychiatrically hospitalize a patient?

A

If they’re not safe anywhere else

30
Q

What is the major issue with suicide contracts?

A

Takes away an “out” patients feel that they have

31
Q

What is the single strongest predictor of attempts at suicide?

A

Prior h/o attempts (even if minor)

32
Q

True or false: personality disorders increase the risk for suicide

A

True

33
Q

What is the risk of suicide for a patient who lost a parent to suicide before the age of 18?

A

3x

34
Q

When, relative to the loss of a loved one, are suicides in related patients particularly high?

A

Anniversary of loss

35
Q

What is a major risk factor for suicides in the adolescent population?

A

Suicide of a close friend

36
Q

What is the major problem with medication and suicide?

A

Increases energy and drive to kill themselves

37
Q

Is fantasy/wish to reunite with a deceased loved one a risk factor for suicide?

A

Yep

38
Q

What happens to regret levels with increasing attempts at suicide?

A

Decreases regret

39
Q

What are the risk factors for multiple attempts at suicide?

A
  • Poorer social problem solving skills

- Comorbid conditions

40
Q

True or false: patients with multiple attempts at suicide usually stick to the same means

A

False–often change their method from nonviolent/non lethal to violent/lethal

41
Q

What are the top three methods of completed suicide?

A
  1. Firearms
  2. Suffocation
  3. Poison
42
Q

What is the top means of attempted suicide (but not completed)?

A

Overdose

43
Q

Guns in the home = a (__)x increased risk of dying with an attempt of suicide?

A

5x

44
Q

What are the three key risk factors for suicide by firearm?

A
  • Social isolation
  • Ready access to weapon
  • Alcohol/substance abuse
45
Q

What is the appropriate approach to a suicidal patient?

A
  • Stay positive

- Manage your own emotional reactions

46
Q

What is the best way to avoid feeling too much empathy towards suicidal patients?

A

Alternate between suicidal and not

47
Q

Why is it particularly important to obtain prior treatment records in assessing a suicidal patient?

A

They may not be honest about their past experiences

48
Q

What should be documented with suicidal patients? (4)

A
  • Face-to-face assessment-
  • Initial and ongoing assessment of suicidal risk
  • Mental status exam
  • F/u on d/t recommendations
49
Q

With suicidal patients, you should make the treatment plan consistent with what?

A
  • dx
  • dynamics
  • suicide risk
  • Capacity of pt to comply
50
Q

What is the best way of protecting yourself against a lawsuit with suicidal patients?

A

Document thinking

51
Q

What are the four major steps in the general approach to suicide risk?

A
  • Elicit information for assessment
  • Place info in context of patient
  • Determine level of intervention
  • Plan the nature and frequency of future reassessments
52
Q

What are the three ways of increasing the protective factors in a patient’s life?

A
  • Pt cooperation around safety concerns
  • Alliance and other supportive relationships
  • Observation or hospitalization
53
Q

What are the two best ways to decrease the strength of risk factors in a suicidal patient?

A
  • Access to weapons, drugs etc.

- Triggering /environmental/ relationships

54
Q

When is hospitalization for a suicidal patient particularly indicated? (4)

A
  • Has no support
  • Has a h/o impulsive behavior
  • Has a plan and clear intent
  • Cannot participate effectively in their own treatment
55
Q

What is the appropriate level of intensity in the response to a suicidal patient?

A

Parallel the probability of suicide

56
Q

What is the major issue with being too involved in the suicidal patient’s life?

A

Trying to do externally what can only be done internally

Psychiatry pro +1700 (28 decks)

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