Deliberate Self Harm Flashcards

(44 cards)

1
Q

Non-fatal deliberate self-harm is more common than suicide. TRUE/FALSE?

A

TRUE

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2
Q

What phrase should not be used in relation to non-fatal deliberate self-harm?

A

“attempted suicide”

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3
Q

Describe the difference of psychiatric illness in patients who die from suicide and those who deliberately self-harm?

A

vast majority of those who die from suicide DO have a psychiatric illness

majority of those who deliberately self-harm do not have a true psychiatric illness - often due to other causes

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4
Q

What is the gender ratio of suicide almost everywhere in the world?

A

Males>females

except certain parts of China

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5
Q

HOw many deaths do the WHO claim are due to suicide each year?

A

800,000

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6
Q

Describe the difference in suicide age peaks between high and low income countries

A

High income countries = less suicide overall, and age peak is middle age

Low income countries = more suicide overall and age peak is late adolescence/young adult

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7
Q

Scotland has the highest suicide rates in the UK. TRUE/FALSE?

A

FALSE

higher than England and Wales BUT lower than Northern Ireland

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8
Q

What are the preferred methods of suicide in Scotland and the rest of the Western World?

A

Hanging (males)

Poisoning (females)

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9
Q

In countries with high suicide rates, both the male and female suicide rates are markedly above that of the UK and other countries. TRUE/FALSE?

A

FALSE

Many countries with high suicide rates have normal female rates of suicide, yet male suicide is significantly high

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10
Q

What area of Europe is thought to have lower suicide rates than others?

A

Mediterranean

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11
Q

What time periods in history showed lower rates of suicide and why?

A

WWI and WWII - due to sense of community and purpose

1960s - change of toxic gas ovens to North Sea gas => less suicide by carbon monoxide poisoning (head in oven)

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12
Q

Rates of suicide increase after coverage of a celebrity dying or committing suicide appears in the media. TRUE/FALSE?

A

TRUE

e. g. Diana Princess of Wales (mainly affected women her age)
e. g. Robin Williams

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13
Q

What theory of suicide relates to Generation X? (i.e. Babies born between 1965 and 1980 - after the baby boomers)

A

The peak age of suicide is following the age which Generation X are becoming each year

  • is this just a more suicidal generation?
  • did something in their adolescence contribute to this?
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14
Q

What change caused a reduction in suicide by poisoning from the 1960s to 70s?

A

Change of sleeping tablets from barbiturates to benzodiazepines
=> patients much less likely to overdose on benzodiazepines

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15
Q

Are suicide rates higher in urban or rural areas?

A

Urban

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16
Q

What season has the highest rates of suicide and why is this thought to be the case?

A

Spring

- due to alienation of vulnerable patients as everyone else is going outside again and getting ready for summer

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17
Q

Being born in what season can increase the risk of suicide in later life?

A

Babies born in Spring months

especially females

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18
Q

Marriage is a protective factor from suicide. TRUE/FALSE?

A

TRUE

- those who are married have lower suicide rates than patients who are single, separated, divorced or widowed

19
Q

What occupations are more at risk of suicide?

A
Unskilled labourers
Construction workers
Doctors
Dentists
Farmers
20
Q

What sub-specialities of Doctor are more at risk of suicide than others?

A

GPs
Anaesthetics
Public Health
Psychiatry

21
Q

Why are Doctors, Dentists and farmers more likely to commit suicide than other occupations?

A

These groups have access to the means to carry out a suicide

22
Q

What features of a doctor make them more susceptible to suicide?

A
  • culture of hiding mental illness/ feeling of shame
  • High stress work environment
  • Qualities of diligence, self-efficacy and perfectionism
23
Q

Describe the EU suicide rates during and after 2008?

A

Suicide rates crashed in 2008 and then began rising again after this

24
Q

Accessibility of a method of suicide will increase the rate of its use. TRUE/FALSE?

A

TRUE

e. g. jumping from height in NYC or Hong Kong due to frequency of multistory buildings
e. g. Switzerland access to guns and ammunition during cold war

25
Who is most at risk from a legally held firearm in America?
Owner (even though many people claim it is to protect them from an intruder) - many suicides occur as a result of possession of firearm
26
What methods of suicide are prominent in Asian countries?
Asia in general - pesticide suicide is common | Hong Kong - charcoal-burning causing CO poisoning
27
What physical health problems can increase the likelihood of suicide?
Chronic pain | Neurodegenerative conditions
28
Only a minority of suicide cases leave a note. TRUE/FALSE?
TRUE | doctors are more likely than most to leave a note
29
What is a suicide pact?
More than one person arranging to commit suicide together or help one another commit suicide. 2/3 of these cases are incomplete and at least ONE person lives
30
What is family annihilation?
Suicidal act where patient kills family (their own or other) and then themself afterwards
31
Explain how patients with a history of deliberate self-harm have abnormal neurobiology
They have less serotonin (5HT) breakdown products in their CSF => serotonin system dysfunction
32
What does neuroimaging show in patients with a high lethality deliberate self harm VS a low lethality deliebrate self harm?
High lethality = more prefrontal cortex activity
33
Suicide rates increase dramatically in ALL twins. TRUE/FALSE?
FALSE Mono-zygotic twins = 13.2% increase Di-zygotic twins = 0.7% increase
34
Adverse childhood events such as sexual abuse can increase suicide rates. TRUE/FALSE?
TRUE
35
Why is smoking not always a useful predictor of suicide?
Suicide rates are increased in patients who smoke BUT psychiatric patients are MORE likely to smoke than patients with other health conditions
36
What mood stabiliser has a reduced risk of suicide compared to others?
Lithium (compared to Valproic Acid/ carbamazepine etc)
37
What are suicide hot-spots?
places where many patients choose to commit suicide | e.g. bridges
38
Why are suicidal prevention messages usually put on bridges/ suicidal hotspots?
Many patients are ambivalent on decision to commit suicide => posters for prevention could change their mind
39
What is meant by an Alcoholic Myopia?
a "pseudo" vision issue where patient's can only see their problems and nothing past them
40
What is NSSI?
Non-suicidal self injury - patient is confident in that they do not wish to die - injuring themself to deal with increased emotins
41
What gender is more likely to deliberately self-harm?
Females > males
42
Low cholesterol causes what effect on suicide risk?
LOW cholesterol increases the risk of suicide
43
What is meant by the "ejector seat" motive?
Patients want to get out of the distressing situation as quickly as possible
44
How should you manage a patient with deliberate self harm?
Calm patient Let them vent emotions in a controlled way Ask about suicide (as this cannot cause it) Involve family and friends as support Make action plan on suicide help app for any further situations