Suicide and deliberate self harm Flashcards
what should you say instead of the phrase “attempted suicide”
non-fatal deliberate self harm
what is the strongest risk factor for suicide
history of deliberate self harm (DSH)
who repeats DSH
previous DSH personality disorder alcohol/drug misuse low socioeconomic class 25-54 years old past psychiatric history unemployed criminal record single/divorced
the closer someone comes to the profile of a suicide completer, the higher the risk of that person completing suicide, true or false
true
who suicides after DSH
males history of DSH older unemployed single/divorced isolated poor health mental health condition violent DSH suicide note
risk factors and associations - suicide
male gender age affluence previous DSH geography seasonal variation marital status occupation genetics availability of method cigarette smoking social media low cholesterol adverse childhood events
motives for DSH
suicide/to die escape anguish, situations display desperation influence others get back at others get help repeat what has helped before
what is the most important thing that should be asked about and explored in risk assessment
hopelessness
management in non-fatal DSH
calm patient
be supportive but firm
direct the interview
deep breathing as a distraction technique
what is the most important history to take after non-fatal DSH
risk assessment and safety net eg Suicide?Help! app
what should be asked about in the history after the initial stage
antecedent events
episode of self harm itself
mental state then and now
what is a positive reinforcement that can be done during the history
bolster self esteem, talk about how brave it is to open up etc
how should follow up be arranged after non-fatal DSH
psychiatry/psychology counselling social work addictions samaritans
patients with a history of DSH have low/high CSF HIAA
low
patients with a history of DSH have increased/decreased binding to 5HT transporters in ventral prefrontal cortex
decreased
