suicide and deliberate self harm

Question 1

deliberate self harm epidemiology

Answer 1

females>males
low socioeconomic status
‘career’ self harmers now >50%
40% of suicides have a history of self harm

Question 2

single strongest risk factor for suicide

Answer 2

History of self harm

Question 3

who repeats DSH

Answer 3

previous DSH, personality disorder, drug abuse, previous psych diagnosis, unemployed, criminal record, 25-54yrs, single separated or divorced

Question 4

who suicides after DSH

Answer 4

older, male, unemployed, single separated, divorced, isolated, poor health, psych diagnosis, violent DSH, suicide note, Hx of DSH

Question 5

Motives for DSH

Answer 5

to die, to escape anguish to escape situation, to display desperation, to get back at people, to get help etc

Question 6

predictor of eventual fatal self harm

Answer 6

hopelessness

Question 7

management

Answer 7

calm patient, be supportive but firm, direct interview
bolster self esteem and problem solving
use family or friends

Question 8

what to ask about after DSH

Answer 8

the episode, mental state then and now

examine the immediate problems- what more do you need to know, who needs to be involved etc

Question 9

Follow up after DSH

Answer 9

psychiatry/psychology, counselling, social work, addiction, samaritans