Suicide and Deliberate Self harm

Question 1

Suicide rates are higher in men or women?

Answer 1

MEN

Question 2

What age does suicide majority affect?

Answer 2

Middle age especially rich countries

Question 3

Neurobiology of suicide?

Answer 3

Patients with history of DSH often have lower CSF-5 HIAA than controls

Question 4

What is CSF 5-HIAA?

Answer 4

Serotonin metabolite

Question 5

SPECT in those just nefore self harm has shown?

Answer 5

Decreased frontal activity

Question 6

Twin studies has proven that there is what component in self harm?

Answer 6

Genetic component

Question 7

Trigger

Female most popular suicide method and males?

Answer 7

Females: poisoning
Males: hanging

Question 8

WHo is DSH most common in?

Answer 8

Women in early adulthood

Question 9

What is the single strongest RF for suicide?

Answer 9

History of DSH

Question 10

Confusion of DSH vs Suicide explained?

Answer 10

Confusing, but deliberate self harm is basically someone deliberately harming themselves in any way without the explicit intention to take their own life
If someone takes an overdose without the intention to die but just thinking they want things to stop that is self harm and this form of self harm is actually a lot more common than cutting

Question 11

Treatment for specific DSH overdose?

Answer 11

Activated charcoal decreases gut absorption of some substances but needs given within 1 hour

-If over 1 our since paracetamol overdose it should be treated with N-acetyl cystine

Question 12

Paracetamol overdose more than 1 hour ago?

Answer 12

N-acetyl cystine

Question 13

Benzodiazepine overdose treated with?

Answer 13

IV flumazenil

Question 14

TCA overdose treatment?

Answer 14

Sodium bicarbonate

Question 15

Assessmnet of suicidal risk consultation? BEFORE

Answer 15

Was there precipitant 
Was self harm planned 
Did patient carry out final acts 
Precautions taken against discovery 
Alcohol used ?

Question 16

Assessment of suicidal risk consultation? DURING

Answer 16

• Method of DSH used
• Patient alone?
• Where were they
• Did they think it would end their life
• Straight after DSH?

Question 17

Assessment of suicidal risk consulttaion? AFTER attempt

Answer 17

• Call anyone, who found them
• How did they feel when help arrived
• Regret attempt
• Current mood
• Still feel suicidal
• If they were to go home now what would you do
• Preventing this from happening again?
• Will patient aceept treatment
• Anythin to live for

Question 18

What else is important to do ina suicide risk consultation?

Answer 18

Screen for other mental disorders

• Bipolar
• Psychosis
• Anorexia

Question 19

What is self harm?

Answer 19

You hurt or harm yourself on purpose

-Indicative feature for suicide risk

Question 20

Who gets (?) self harm?

Answer 20

• Females > males

- Northern Europe > southern

Question 21

Risk assessment for DSH?

Answer 21

SAD PERSONS scale

S: Sex (1 if male)
A: Age (if <20 >44)
D: Depression (1 if present)
P: Previous attempt (1 if present)
E: Ethanol abuse (1 if present)
R: Rational thinking loss (1 if present)
S: Social supports lacking (1 if present)
O: Organized plan (1 if made and lethal)
N: No spouse (1 if divorced, widowed, separate or single)
S: Sickness (1 if chronic)