Flashcards in Suicide Deck (21):
Asking mom with kids and depression: must add
Ever wish your kids were not born?
Predictors of suicide?
High levels of loss of pleasure
Recent onset of panic attacks
If GP, and presented with suicide: give what?
Make sure they can sleep
When to see someone who is alcoholism intensely for 1-2 months post?
After loss of significant relationship
Other predictors of suicide?
Previous failed attempt (100x) especially if older
First day-week-month after discharge from a psych unit
Aging isolated makes
Low cholesterol (building block for serotonin)
Low serotonin metabolite in CSF (5HIAA)
What influences suicide?
The media - details or glamorized
Youth suicide increased risk factors
80% discussed with close friends/family
Youth suicide pathways? 3 groups
Depressive perfectionist if pathway
Aggressive impulsive cluster
Politically correct terms:
Died from suicide (not committed)
Complete suicide (not successful)
Circumstances (indicator of determination)
Deliberate self harm
Or suicide but survived
How to assess determination to die
Sudden decision? Or something thinking about for a while?
anyone contacted after the act?
Were there precautions against discovery.
Suicide prevention how to ask?
1. Wish you didn't wake up in the morning?
2. Actually wish you were dead?
3. Self-rating of active suicide risk on 0-10scale
Extended suicide prevention questions
Thought of doing something
Contemplated ways, check internet?
Been close to attempt
Attempts in past especially planned
Willingness to use violent methods (85% of suicides)
When in doubt for preventing suicide?
Give them antidepressant
How to start antidepressant in suicidal patients?
Low dose for 2 days
Normal dose 1 week;consider increasing at end of week 1
Ensure sedation (and sleep) in anxious or agitated suicidal patients = quitiapine 25mg or benzodiazepines (won't OD)
Or sedating antidepressant: mirtazipine or Agomelatine)
Intervention techniques in suicide to say:
You would never advise a friend to die
Tell yourself what you would tell a friend!
Intervention techniques include:
-Reassurances guarantees of recovery
-withhold/mislead info re lethality (copycat suicides)
-allow access to non-fatal oblivion
-See them freq. promise me you won't hurt yourself before I see you. --Be available
-Don't take alcohol/drugs
-voluntary or compulsory admission
What are Non-lethal medications to give in suicide?
Intervention techniques beware of:
"Terminal malignant alienation"
Desensitized to suicide