Suicide & Violent Behavior

Question 1

What fraction of those who attempt suicide will communicate their intentions to others?

Answer 1

2/3

Question 2

What is the single greatest predictor of future suicide?

Answer 2

past history of suicide attempts

Question 3

What percent of all suicide completers have alchol in their bloodstresam at time of death? Why is this so common?

Answer 3

40%

(90% of alcoholic suicide completers)

alcoholy may have been th disinhibiting agent prior to suicide

Question 4

What is the ratio of male:female suicide rates among physicians

Answer 4

equal

in the general population males complete suicide 4x mor often than females, but female physicians have a rate equal to male physicians

Question 5

What are the major risk factors for physician suicide?

Answer 5

depression

bipolar disorder

alcohol

substance abuse

Question 6

What fraction of physicians are affected by burnout by the end of their intern year?

Answer 6

1/3

Question 7

What are the symptoms of burnout?

Answer 7

emotional exhaustion

depersonalization

sense of decreased personal accomplishment

Question 8

What fraction of depressed interns seek mental health services?

What are the reasons for not seeking help?

Answer 8

1/2

• lack of time
• lack of confidentiality
• desire to manage mental helaht independently
• professional stigma

Question 9

Are males or females more likely to have suicidal thoughts?

Answer 9

females

Question 10

10-15% of all patients with what disorders will eventually successfully suicide?

Answer 10

depressive disorder

bipolar disorder

schizophrenia

Question 11

What is the pneumonic for highest suicide potential?

Answer 11

• S - sex (male)
• A - age (older)
• D - depression
• P - previous suicide attempt
• E - ethanol abuse
• R - rational thinking loss
• S- social support lacking (perceived or real)
• O - organized plan
• N - no spouse
• S - sickness

Question 12

What is the most important question you can ask a patient to assist in determining suicidal potential?

Answer 12

Are you haveing any thoughts of wanting to hurt yourself, wanting to die, wanting to commit suicide?

Question 13

What is an ominous sign tha ta person as made peace with their intent to die?

Answer 13

becomes quiet & less agitated

Question 14

What is a treatment that provides rapid relief for overwhelming depression & suicidal ideation?

Answer 14

electroconvulsive therapy

Question 15

What are the best predictors of future violence?

Answer 15

single best predictor - past history of violent behavior

childhood aggression

alcohol use

Question 16

Why is there an association between alcohol & violent behavior?

Answer 16

chemical function of disinhibition. disturbance of perception, imairment of judgement and aletrness

Question 17

What is a physilogic marker for violent/impulsive behavior?

Answer 17

low CSF level of 5-HIAA

Question 18

Cutting is commonly seen in patients with what disorder?

Answer 18

borderline personality disorder

Question 19

What are the areas commonly used in the act of cutting?

Answer 19

wrists, arms, thighs, and legs