Piasecki: Psychiatric Emergencies and Forensic Psychiatry Flashcards
(29 cards)
What is the ratio of suicide to homicide in Nevada?
2:1
T/F: People living in rural Nevada commit suicide at much more than twice the rate of the nation as a whole
Geriatric even higher
Military higher yet
True
Ranks as the 11th cause of death
*#6 cause of death in men in Nevada
suicide
How are most suicides committed?
firearm
Most common gender to commit suicide? Most common race?
male; whites and american indian/Alaskan native
Why might the Western states have increased prevalence of suicide?
more depression in these states
more gun ownership?
elevation
Which age group is at the highest risk for suicide?
elderly
Which small molecule might be decreased in the CSF in patients who commit suicide, especially violent suicide?
5HT
Does suicide have a genetic link?
yes! increased concordance in monozygotic twins
Which medical illnesses lead to increased suicide risk?
cancer
AIDS
COPD
hemodialysis
**chronic illnesses w suffering each day and little hope to improve
T/F: People who are married are at a decreased risk of suicide
true
Increased risk of suicide in these psych disorders
major depression/bipolar
alcoholism
schizophrenia
personality disorders
T/F: 50% or more of suicide pts will have seen their primary care doc w/i weeks before their death. In addition, most people spoke about their suicide the day of their death.
True
What are some reasons that people commit suicide?
intimate partner problems
physical health problems
finances
job problems
What is used to screen for depression?
ASQ in EDs
Beck depression inventory
How do you intervene if you think someone might be suicidal?
consultation (refer them to ER)
hospitalize them
suicide precautions (while in the hospital, observe them, put them in PJs, search their belongings)
follow up
Do demographic suicide risk factors help predict short term outcomes for individuals?
no, they describe populations, not individuals
What do we have in NV for suicidal pts?
crisis call center
Intent: not to die
A maladaptive solution to chronic problems
Behaviors may include self mutilation, overdose
Not taking care of a medical condition
parasuicidal behavior
What are some clues to a violent patient?
history of violence age/gender/gang affiliation **substance use antisocial personality disorder psychopathy self destructive behavior
3 ways you can assess violence?
look for current substance abuse
do an MSE: look for paranoia, cognitive impairment, hallucinations
past history of violence
What is our duty as a physician if we encounter a violent patient?
it’s our duty to warn and protect the target of violence (call the police)
What form of suicide results in the most deaths by suicide? What form of suicide results in unsuccessful suicide?
firearm; poisoning (OD)
Which progressions increase the risk for suicide?
women physicians
military
