Week 7 Flashcards
What are the key steps in suicide risk assessment that need to be determined?
Plan
Means
Timeframe
History of previous attempts
What is a suicide safety plan?
list of coping strategies for use during suicidal crisis
should be first intervention
enhances patients sense of control
what are some suicide risk factors?
History Life stressors Psychiatric disorders Physical changes Behaviour Demographics Thoughts Feelings
how many people die from suicide in australia?
9.1%
3/4 being male
leading cause of death for people 15-44
What is Dysthymia?
less severe but usually longer lasting type of depression
involving chronic symptoms that don’t disable a person but prevent them form being 100%
What are some major complications that can arise from CNS stimulant toxicity?
Hyperthermia
What are some examples of ‘Psychiatric disorders’ as a suicide risk factor?
depression
schizophrenia
personality disorders
alcohol/substance abuse
What are the key ECG findings of TCA Toxicity?
QRS widening PR prolonged QT prolonged Right axis deviation RBBB Tachnycardia
What is the triad of symptoms of serotonin syndrome?
Autonomic instability
neuromuscular hyperactivity
mental status changes
what are the cardio vascular effects of Amitryptyline
sinus tachy/hypertensionhypotension/
What are some examples of ‘History’ as a suicide risk factor?
- past attempt
- family history of completed suicide
- know someone who has
- childhood trauma
What are the primary classifications of bipolar disorder?
Bipolar 1
Bipolar 2
Cyclothymic disorder
what are the 5 stages to the Kubler-Ross grief cycle?
- Shock and denial
- Anger
- Depression and detachment
- Dialogue and Bargaining
- Acceptance
What are some examples of ‘Physical changes’ as a suicide risk factor?
lack of energy
insomnia
loss of appetite
physical illness
What are some examples of ‘Behaviour’ as a suicide risk factor?
substance abuse
impulsivity
withdrawl
recklessness
WHat is the difference between Bipolar 1 & 2?
1 and 2 differ in length and intensity of the high.
1 requires one experience of mania but does not require episode of depression.
what are the CNS effects of Amitryptyline
delirium/confusing/sedation/seizures/coma
what are trycyclic antidepressants?
noradrenaline and serotinin reuptake inhibitors
and
GABA -A receptor blockers
What are the signs and symptoms of TCA toxicity?
- drowsiness/confusion
- tachycardia
- slurred speech
- hyperreflexia
- hypertension
Sever symptoms:
- coma
- resp depression
- dysrhythmias
- hypotension
- seizures
What are some examples of ‘Life stressors’ as a suicide risk factor?
lack of supports relationship problems unemployment sexual abuse pain
What causes the cardiotoxic effects of trycyclic antidepressants?
blackade of inactivated fast sodium channels
What are key protective factors to depression?
strong relationships social networks religion school/employment dependent children
What is postnatal depression?
lasts more than a 1-2 weeks and affects functioning on daily basis
What are common clinical symptoms of CNS stimulants?
tachycardia hypotension dilated pupils dysrhythmias diaphoresis agitation hyperthermia seizures
What can happen with TCA OD?
Life threatening cardiac dysrhythmias
What level of QRS widening in TCA toxicity is associated with seizures?
> 100ms
> 160ms is associated with cardiac dysrhthmias
What are the 2 types of suicidal ideation?
Passive - thoughts without nay intent
Active - plans etc
What are some examples of ‘feelings’ as a suicide risk factor?
hopelessness desperate disconnected worthless agitation
what is australias major cause of OD fatalities?
trycyclic antidepressants
What are some examples of ‘demographics’ as a suicide risk factor?
male living alone divorced/widowed LGBTI indigenous
What is serotonin syndrome?
too much serotonin in brain or periphery
What are the 4 branches in the AV CPGS under overdose?
Opioids
TCA antidepressants
Sedatives
Psychostimulants
According to AV CPG’s what are the 3 signs of TCA toxicity?
- QRS >0.12
- hypotension
- ventricular arrhythmias
Quetiapine OD effects include?
coma
anticholinergic delirium
prolonged QT
Doses >3g cause coma
What are common psychotherapies for major depressive disorder?
cognitive-behavioural therapy
Interpersonal psychotherapy
Mindfulness based cognitive therapies
What are the primary classifications of depressive disorders?
Disruptive mood dysregulation disorder
persistent depressive disorder
major depressive disorder
What are some examples of ‘thoughts’ as a suicide risk factor?
current plan talk of death no future escape alone
What are the cardiovascular effects of CNS stimulants?
sympathomimetic, vasospastic and sodium channel blocking
blocks fast sodium channels
increased intracranial haemorrhage risk
acute cardiomyopathy
pulmonary oedema
What are some symptoms of bipolar?
elevated irritable mood increased activity or energy increased self esteem decreased need for sleep pressured speech distractibility
WHat are the 2 categories of mood disorders?
Bipolar disorders
Depressive disorders
