suicide risk

Question 1

56 y.o. man brought to A+E following an overdose of amitriptyline

(a) what is the most concerning toxic effect of amitriptyline and how should this be assessed?

Answer 1

toxic effect → arrythmia 2˚ to QT prolongation

assess using ECG

Question 2

after appropriate medical rx, you interview him with a view to asses his mental state

(b) give 4 findings in the hx which would be suggestive of serious suicidal intent

Answer 2

1. leaving a note
2. planning
3. undertaking when unlikely to be discovered/interrupted
4. did not inform anyone
5. pt sure that their actions would result in death
6. pt truly wanted to die
7. pt would have died without medical intervention
8. pt upset that they have failed in their attempt
9. on-going suicidal intent

Question 3

(c) what is the most important aspect of risk assessment to consider?

Answer 3

on-going suicidal intent

Question 4

(d) list 3 underlying psychiatric disorders most associated with raised suicide risk

Answer 4

1. bipolar affective disorder
2. schizophrenia
3. depression