Suicide and self harm

Question 1

Define suicide

Answer 1

Deliberate self-inflicted death

Question 2

Who is most at risk of suicide?

Answer 2

Men aged 40-50
Isolation and lack of social support
Unmarried
Adverse life events
Mental illness & drug addiction
Chronic painful illness
FH of suicide
Reduced brain derived neurotrophic factor at postmortem

Question 3

What % of deaths are suicides in UK?

Answer 3

1%

Question 4

What are the common methods of suicide?

Answer 4

In USA: firearms
In UK: hanging and self poisoning
Jumping infront of train/car
Exsanguination

Question 5

How much more common is DSH than suicide?

Answer 5

20-30% more common

Question 6

Most common forms of DSH

Answer 6

Drug overdose

Physical self injury (cutting/stabbing)

Question 7

What psychiatric disorder is most commonly associated with DHS?

Answer 7

EUPD

To release tension, can’t cope with intense emotions

Question 8

Why is DSH done?

Answer 8

To interrupt a sequence of events seen as inevitable/undesirable
For attention
As an attempt to communicate
A true wish to die

Question 9

Management of DSH

Answer 9

MEDIATE
Medically stabilise
Establish rapport
Diagnose and treat mental illness (DBT in EUPD)
Iatrogenic risk (prescribe safely)
Assess likelihood of recurrence
Thought may return-> make a plan
Evaluate social problems

Question 10

Prognosis after DSH

Answer 10

1/5 will repeat act within a year

Suicide risk is 100 times higher than in general population