Suicide and self harm Flashcards
which social classes are at highest risk of suicide?
1 and 5
which social classes are at highest risk of self harm?
4 and 5
strongest predictor of future suicide?
non-fatal self harm with clear suicide intent
what is the aetiology of suicide?
- Social causes;
A. Isolation, social class, stressful job - Mental health:
- depression, schizophrenia, personality disordes etc
- Physical health
- terminal/chronic illness - Family hx
what is suicide risk in a severely depressed who is recovering?
very high
as have energy to act on intents
list 3 suicide prevention strategies employed by uk gov?
• limiting pack sizes of paracetamol
• installing barriers at suicide ‘hotspots’ and providing
a free telephone for calling the Samaritans
• catalytic converters (these have decreased the suicide
rate from inhaling car exhaust fumes).
which is the most common form of self harm?
self cutting
-> but overdoses seen more in hospitals
list reasons for self harm
Avoiding more dangerous self-harm or suicide
• Self-punishment (e.g. for being fat, stupid, etc.)
• Suicide attempt
- Substituting psychological distress with physical pain
- Overcoming numbness
- To change intolerable situations (often relationship issues)
name 1 theory for self harm?
self-harm as a way of dealing
with difficult emotions when the ability to mentalize
is poorly developed or damaged
becaue of abusive or neglective childhood
so lack of ability to reflect on emotions
rx for antidepressant overdose?
activated charcoal
rx for paracetamol overdose?
n acetyl cysteine
rx for Lacerations?
– Superficial cuts: suture/close with Steristrips
– Plastic surgery for deep cuts with nerve or tendon
damage
– Adequate analgesia must be given while suturing
lacerations
which aspects of self harm are regarded as greater risk —- so likely to attempt harm again in future?
Careful planning (duration and attention to detail)
- Final acts in anticipation of death (e.g. writing wills)
- Isolation at the time of the act
• Precautions taken to prevent discovery (e.g. locking
doors)
• Writing a suicide note
• Definite intent to die (rather than to change, or temporarily escape, a situation)
• Believing the method to be lethal (even if it wasn’t)
• Violent method (e.g. shooting, hanging, jumping in
front of a train)
• Ongoing wish to die/regret that the attempt failed
when do we admit a patient to psych ward in cases of self harm?
high risk of suicide?
which antidepressants are best for those who have risk of overdose?
SSRIs
- but still review prescriptions regularly to try and prevent
stockpiling for an overdose.
