Suicide Flashcards Preview

Jason's MD3 Psychiatry Rot > Suicide > Flashcards

Flashcards in Suicide Deck (21):
1

Asking mom with kids and depression: must add

Ever wish your kids were not born?

2

Predictors of suicide?

Hopelessness
Insomnia

High levels of loss of pleasure
High anxiety
Recent onset of panic attacks

3

If GP, and presented with suicide: give what?

Antidepressants
Make sure they can sleep

4

When to see someone who is alcoholism intensely for 1-2 months post?

After loss of significant relationship

5

Other predictors of suicide?

Previous failed attempt (100x) especially if older

First day-week-month after discharge from a psych unit
Early dementia
Alcohol
Aging isolated makes
Chronic pain
Family Hx
Low cholesterol (building block for serotonin)
Low serotonin metabolite in CSF (5HIAA)

6

What influences suicide?

Spring
Children
Partners
Mondays
The media - details or glamorized

7

Youth suicide increased risk factors

Self harm
Copycat suicide
80% discussed with close friends/family

8

Youth suicide pathways? 3 groups

Depressive perfectionist if pathway
Aggressive impulsive cluster
Disintegrating cluster

9

Politically correct terms:

Died from suicide (not committed)
Complete suicide (not successful)

10

Attempted suicide

Seek oblivion
Circumstances (indicator of determination)
Psychiatric history

11

Parasuicide is?

Deliberate self harm
Or suicide but survived

12

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.

13

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

14

Extended suicide prevention questions

Thought of doing something
Contemplated ways, check internet?
Plans
Preparations
Been close to attempt
Attempts in past especially planned
Willingness to use violent methods (85% of suicides)

15

When in doubt for preventing suicide?

Give them antidepressant

16

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)

17

Intervention techniques in suicide to say:

You would never advise a friend to die
Tell yourself what you would tell a friend!

18

Intervention techniques include:

Maintain HOPE.
-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
-urgent referral
-voluntary or compulsory admission

19

What are Non-lethal medications to give in suicide?

Benzos, quetiapine

20

Intervention techniques beware of:

Giving gifts
Suddenly calmness
"Terminal malignant alienation"

Desensitized to suicide

21

Major predictor of suicide?

Hopelessness