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PEDIATRICS > SUICIDE & ATTEMPTED SUICIDE > Flashcards

SUICIDE & ATTEMPTED SUICIDE Flashcards

1
Q

What was the second leading cause of death in adolescents and young adults in 2021?

A

Suicide

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2
Q

What percentage of 9th-12th grade students in the U.S. seriously considered attempting suicide in the previous year?

A

0.188

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3
Q

What is the most common method of attempted suicide in adolescents?

A

Ingestion

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4
Q

Which age group is most likely to intentionally harm themselves by ingestion?

A

15-19 years old

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5
Q

Which demographic group has the highest rates of suicidal ideation and suicide attempts?

A

LGBTQ+ and bullied youths

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6
Q

What is a significant risk factor for suicide in adolescents who have made prior suicide attempts?

A

No regret, having a plan, or still wanting to die

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7
Q

What is the most common method of suicide completion across all ages and genders in the U.S.?

A

Firearms

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8
Q

Which age group has the highest suicide completion rates in the U.S.?

A

Ages 20-24

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9
Q

Which demographic group has the highest suicide rates in youth ages 15-24?

A

Indigenous American and Indigenous Alaskan youth

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10
Q

What are dynamic risk factors for suicide in children and adolescents?

A

Psychiatric symptoms, psychosocial stressors, changes in treatment

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11
Q

What are static risk factors for suicide in children and adolescents?

A

Genetics, past psychiatric history, family history of suicide

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12
Q

What is the death rate associated with suicide by firearms?

A

80-90%

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13
Q

What method has the highest death rate for suicide in adolescents?

A

Firearms

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14
Q

What factor has been shown to reduce suicide rates when limited?

A

Access to firearms

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15
Q

What is suicide contagion?

A

The phenomenon where exposure to news of a suicide leads to an increase in suicides, especially among adolescents

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16
Q

What is the most common preexisting psychiatric illness linked to youth suicide?

A

Major depression

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17
Q

What is the most significant risk factor for future suicidal behavior in adolescents?

A

History of a previous suicide attempt

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18
Q

What is nonsuicidal self-injury (NSSI)?

A

Direct and deliberate destruction of one’s body tissue without intent to die

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19
Q

What percentage of youth with depression engage in NSSI?

A

Up to 47.4%

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20
Q

What percentage of adolescents who engage in NSSI report a lifetime suicide attempt?

A

0.7

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21
Q

What are protective factors against suicide in children and adolescents?

A

Positive coping skills, fear of consequences, responsibilities for others

22
Q

What is the most reliable way to assess suicidality in youth?

A

Direct and nonjudgmental questioning about suicidal ideation, plans, and behaviors

23
Q

What is the recommended level of psychiatric care for youth with imminent danger to themselves?

A

Inpatient psychiatric care

24
Q

What should pediatric practitioners do when managing youth at risk of suicide in the outpatient setting?

A

Schedule an appointment with a mental health clinician within a few days

25
Q

What should clinicians explore during a suicide attempt assessment?

A

Precipitating factors, circumstances of the attempt, and intent

26
Q

What is a key aspect in the assessment of suicidal ideation in children?

A

Understanding of death and cognitive development

27
Q

What is the most common precipitating factor for suicide in children under 12?

A

Relationship problems, especially with family

28
Q

What is the most likely method of suicide in Black male children?

A

Hanging or strangulation

29
Q

What is the highest risk factor for suicide among adolescents?

A

Previous suicide attempts

30
Q

What is the primary goal of assessing suicide risk in youth?

A

To determine the level of risk and plan appropriate intervention

31
Q

Which protective factor involves having someone to care for, such as children or pets?

A

Responsibilities for others

32
Q

What is a warning sign of suicide involving risky behavior?

A

Acting recklessly or engaging in risky activities without thinking

33
Q

What is an example of a warning sign of suicide related to substance use?

A

Increasing alcohol or drug use

34
Q

What are some prevention strategies for suicide in the pediatric medical home?

A

Prevention strategies include training staff to recognize and respond to warning signs, screening for and treating depression, educating patients/parents about warning signs, and restricting access to lethal means (e.g., firearms, medications, alcohol).

35
Q

Why is suicide screening in the pediatric population challenging?

A

Suicide screening is challenging due to variable sensitivity and specificity of most screening instruments, poor follow-up evaluations, and patients attempting to conceal or downplay their suicidal thoughts.

36
Q

What does the American Academy of Pediatrics recommend for suicide screening in children?

A

The American Academy of Pediatrics recommends universal suicide screening for all children ≥12 years old.

37
Q

What are the common screening tools for suicide risk in pediatric patients?

A

Common screening tools include the Ask Suicide-Screening Questionnaire (ASQ), Columbia Suicide Severity Rating Scale (C-SSRS), and the Patient Health Questionnaire (PHQ-2/PHQ-9).

38
Q

What should pediatric practitioners do if a child or adolescent screens positive for suicide risk?

A

Pediatric practitioners should consider further mental health assessment, implement psychotherapies, and possibly use psychotropic medications, along with promoting social connectedness and wellness behaviors.

39
Q

What are the recommended treatments for pediatric patients with suicidal ideation or behavior?

A

Effective treatments include dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), and appropriate psychopharmacology, often in conjunction with a child and adolescent psychiatrist.

40
Q

What role does social connectedness play in suicide prevention for youth?

A

Encouraging social connectedness to peers and community organizations can help reduce suicide risk by fostering support networks and promoting help-seeking behaviors.

41
Q

What screening tool is shown to have high sensitivity and negative predictive value in identifying youth at risk for suicide?

A

The Ask Suicide-Screening Questionnaire (ASQ) is a validated four-item measure with high sensitivity and negative predictive value.

42
Q

What is the efficacy of gatekeeper training for suicide prevention in schools?

A

Gatekeeper training is effective in improving skills among school personnel and is highly acceptable to administrators, but it has not been shown to prevent suicide.

43
Q

What are the potential benefits of school curricula like ‘Signs of Suicide’?

A

School curricula such as ‘Signs of Suicide’ can help teach students to recognize signs of depression and suicide in themselves and others and provide steps for responding to these signs.

44
Q

What is the role of peer helpers in suicide prevention in schools?

A

Peer helpers have not generally been shown to be effective in preventing suicide in schools.

45
Q

What is the Columbia Suicide Severity Rating Scale (C-SSRS) used for?

A

The C-SSRS is a tool to assess suicide risk in patients by asking about thoughts, intentions, and behaviors related to suicide.

46
Q

What should be done if a patient answers ‘Yes’ to question 1 on the Columbia Suicide Severity Rating Scale?

A

A mental health referral should be made at discharge if the patient answers ‘Yes’ to question 1.

47
Q

What is the response protocol if a patient answers ‘Yes’ to question 2 on the C-SSRS?

A

A mental health referral should be made at discharge if the patient answers ‘Yes’ to question 2.

48
Q

What should happen if a patient answers ‘Yes’ to question 3 or 4 on the C-SSRS?

A

Care team consultation with a psychiatric nurse and patient safety monitor/procedures should be implemented.

49
Q

What is the protocol if a patient answers ‘Yes’ to question 5 or 6 on the C-SSRS?

A

Psychiatric consultation and patient safety monitor/procedures should be initiated.

50
Q

What is the response protocol if the patient answered ‘Yes’ to question 6 and the event occurred within 3 months?

A

If the event occurred within 3 months, psychiatric consultation and patient safety monitoring procedures should be followed.

51
Q

What should be done if the event occurred more than 3 months ago and the patient answered ‘Yes’ to question 6 on the C-SSRS?

A

If the event occurred more than 3 months ago, a mental health referral should be made at discharge.

PEDIATRICS (17 decks)

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