Suicide

Question 1

who is at greatest risk for suicide?

Answer 1

middle age white men

Question 2

chronic risk factors

Answer 2

anxiety, agitation, panic attacks, insomnia, restlessness, irritability, hostility, aggressiveness, impulsivity, hypomania and mania, hopeless and helplessness

Question 3

risk triad

Answer 3

ideation (thoughts/ideas of suicide)
intention (do you intend to do it)
plan (do you have a plan)

Question 4

epidemiology/demographics

Answer 4

rates vary from country to country. Almost always due to mental illness

Question 5

which age group has seen a spike in suicide?

Answer 5

adolescents (15-19 years)

Question 6

women vs. men suicide

Answer 6

men more successful, women attempt more. women usually use less lethal methods such as overdose

Question 7

ethnicity in suicide

Answer 7

blacks have lower rates than whites. immigrants have higher rates of suicides.

Question 8

marital status in suicide

Answer 8

lowest if married especially if kids are in the home. higher rate if separated, divorced, or widowed. anniversary suicides: person kills self on important date

Question 9

religion in suicide

Answer 9

lower in catholics and islamics. higher in protestants and jews

Question 10

occupation in suicide

Answer 10

higher in professionals than non professionals. higher in physicians, dentists, vets (access to drugs). higher in cops (access to guns). higher in musicians and attorneys. fall in status also increases risk. rate higher in unemployed vs. employed

Question 11

physicians in suicide

Answer 11

female physicians have higher risk of suicide than any other women. docs who kill self usually have mental disorder/depression/substance abuse. psychiatrist are greatest risk, followed by opthamologist and anesthesiologists.

Question 12

other risk factors for suicide

Answer 12

substance abuse, aggressive / impulsive behavior, genetics, family history, climate

Question 13

genetics involved in suicide

Answer 13

5-HTT gene polymorphism. ss short allele for serotonin transporter seems to convey poor resilience and increased suicide risk when faced with stress. LL seems protective. l/s is in the middle

Question 14

treatment of suicide

Answer 14

interview about triad. take good history about risk factors. ask about protective things that keep them alive. use least restrictive approach.

Question 15

hospitalizing a suicide patient

Answer 15

if patient is at high risk for suicide and does not want to be hospitalized, patient can be detained for 1-63 days. physicians legally responsible if they do not recognize a suicidal patient or they give a drug later used in a suicide

Question 16

antisuicide prescriptions???

Answer 16

If under age of 24, antidepressants may raise risk of suicide. Electroconvulsive therapy is quick fix. ketamine is experimental. lithium and clozapine are FDA approved for suicide prevention in bipolar and schizophrenic patients