Term
| What are the 4 major factors that get in the way of accurately predicting those at risk for suicide attempts? |
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Definition
second highest cause of death in youth
1) Low base rate of suicide
- many will think about it from time to time and few will attempt
2) Multifactorial nature of suicide
- Demographics, History, Contextual situation, illness, values, ect (how do you weight them?)
3) Suicide risk varies over time in an individual
- Adolescence and late in life
4) Historical factors affect risk
- Regulations and access |
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Term
| What is the relationship between Mood disorders such as MDD, Bipolar and Schizoaffective disorder and Suicide risk? |
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Definition
| All 3 are positively related, as well as Chronic Alcoholism and Substance abuse |
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Term
| What populations are at greatest risk for suicide? |
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Definition
15% of people with depression (95% who die of suicide are experiencing psychiatric episode)
1) Gender- Male > Female
2) Race- White >Black
3) Age- Old> teen> adult
4) Religion- Protestant> Catholic
5) Occupation- MD/dentists at risk
6) Geography- Rural> Urban and West > East
** Highest in youth ages 20-24 (12.5 per 100,000)
- 15-19 (8.2 in 100,000)
- 10-14 (1.3 in 100,000) |
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Term
| What are the most common methods of suicide by gender? |
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Definition
Firearms most common for men and Poisoning for women
1) Males
- Firearms 56%
- Suffocation 23%
- Poisoning 13%
2) Females
- Firearms 31%
- Suffocation 19%
- Poisoning 40% |
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Term
| What are the acknowledged biological correlates of suicide? |
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Definition
5-HT function
- Polymorphisms found in those subject to violent attempts
- Low levels of metabolite in CSF |
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Term
| What is the Stress-Diathesis Model of Suicide Risk? |
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Definition
1) Diathesis (genetic predisposition) is influenced by Long-term and Short-term risk factors, and predicts suicide likelihood
- Long term suicide attempt history, psychiatric disorders, family history of suicide, violent/impulsive history, isolated/poor/male
- Short term include current ideation/plan, current psychiatric d/o's: mood, substance, psychosis, Deparation, Communication breakdown
2) Suicide likelihood also influenced by stressors/triggers
3) Protective factors include
- Social support
- Spirituality
- Sense of responsibility to family
- Children in home
- Life satisfaction
- Coping skills |
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Term
| What are the basic principles of suicide risk management? |
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Definition
SAID Dead
1) Screen for Ongoing suicide risk
2) Asses for current suicidal ideation and behavior
3) Identify Protective factors
4) Determine level of risk and treatment/Triage plan
5) Document plans and communicate to others |
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Term
| What questions should you ask when screening for suicide risk? |
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Definition
Over 50% who die from suicide have seen their physician within last month!
1) Psychiatric conditions
- Depression, SZC, Psychoses, Alcoholism, S/A, Panic, PTSD, HIV
2) Access to firearms/weapons
3) Lifetime history of ideation |
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Term
| How can you best assess for current suicidal ideation and behavior? |
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Definition
| Get a referral for a specialist and don't be afraid to ask the hard questions! |
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Term
| What protective factors should be identified when evaluating a patient for suicide risk? |
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Definition
Protective factors include
- Social support
- Spirituality
- Sense of responsibility to family
- Children in home
- Life satisfaction
- Coping skills |
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Term
| How do you determine level of risk and treatment/Triage plan? |
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Definition
1) Focus on most important risk factors
- History of serious or nearly lethal attempt
- Persistent ideation
- Acute risk factors (severe depression, recent discharge, change in medication)
- Means to attempt are available
2) Probably best to admit and definitely review history with family to identify short-term risk factors. |
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Term
Which of the following age groups has the highest risk for suicide?
a. Adolescents
b. Women between 25 and 50 years
c. Men between 25 and 50 years
d. Elderly |
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Definition
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Term
Suicide is most common amongst which of the following groups?
a. Black Males
b. White Males
c. Asian females
d. White females |
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Definition
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Term
Which statement best describes the approach physicians should take in asking patients about suicide:
a. Don’t ask patients unless they spontaneously offer information; asking about suicide can increase the risk in vulnerable patients.
b. When the patient says they’ve been thinking about cutting themselves, ask whether they would do that to cause themselves pain or to end their life.
c. If a suicidal patient is Catholic, remind them of religious prohibitions against suicide in an effort to restrain them from acting on their thoughts.
d. All of the above |
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Definition
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Term
If you identify a suicidal patient, what management step(s) would be most appropriate?
a. Refer for psychiatric consultation
b. Recommend hospitalization
c. Discuss the case with the family
d. A+B
e. All of the above |
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Definition
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Term
Why are men more likely to complete suicide?
a. Women say they’re suicidal but don’t really intend to kill themselves.
b. The problems that men face that lead to suicidal ideation are much greater than the problems that women face.
c. Men choose more lethal means (especially firearms).
d. Men are NOT more likely to complete suicide; gender completion rates are equivalent. |
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Definition
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Term
All of the following are appropriate steps in managing suicidal patients, EXCEPT:
a. develop a safety plan
b. remove firearms
c. don't ask about suicidal intent (to avoid "planting the seed")
d. observe the patient frequently |
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Definition
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Term
Of the following classes of psychiatric disorders, which carries the highest risk for suicide:
a. sexual disorders
b. substance use disorders
c. dissociative disorders
d. eating disorders |
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Definition
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Term
The most consistent biological correlate of complete suicide is:
a. alterations in serotonergic functioning
b. low levels of urinary free cortisol
c. elevated HVA levels in the cerebrospinal fluid
d. frontal hypoperfusion seen on fMRI |
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Definition
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