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25 Cards in this Set

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3 psychiatric disorders that suicide "cuts across"
(i.e. has significant co-occurence with)
Depression
Alcoholism (i.e. substance abuse)
Schizophrenia
% of people who commit suicide who have psych illness @ the time
90%
What is "parasuicide"?
Low lethality suicide attempts w/ greater expectation of rescue
Description of pt. more likely to "commit" "parasuicide"
(age, sex, disorders, etc.)
Young (< 35)
Female
Adjustment disorder, Cluster B Personality Disorder
Description of pt. more likely to "complete" suicide
(age, sex, disorders, etc.)
Older (> 60)
Male
MDD, psychotic disorder, substance-related disorder (esp. alcohol)
What is the major cause of death in jail?
Suicide
5 STATIC risk factors for suicide
Demographic variables
Psychiatric diagnosis
Prior suicide attempts
Medical illness
Trait vulnerabilities (i.e. personality disorder)
Do Males or Females attempt suicide more?

Which group is more successful at completing it?
Females attempt it 3-4x more frequently

Males are successful 2-3x more frequently
What is the age distribution for black & white males for the suicide rate?
BOTH groups peak between ages 20 and 40

Black males increase again after 75
White males increase again after 65
(continues to increase w/ age)
Who makes more attempts at suicide, young people or old people?

Who is more likely to succeed?
Younger people make more attempts

Older people are more likely to succeed
Depression is found in what % of completed suicides?
30 - 70%

25% of MDD pts. attempt
15% ultimately succeed
Sensitivity and specificity characteristics of symptom of hopelessness
High sensitivity
Low specificity
% of those who commit suicide w/ diagnosis of alcoholism
20%
% of suicides that occur within 1 year of last hospitilization
40%
% of schizo pts. who attempt, and who succeed at suicide

When, in course of illness, do most suicides occur?
30% attempt
10% of pts. succeed

Most often during 1st year of illness
(after multiple admissions)
What is the best predictor of future behavior?
Past behavior
When is the risk highest for a suicide attempt?
(in a person who has attempted before)
During the year following the previous attempt
Stressors in adolescents that are most likely to induce suicide
Interpersonal conflicts
Separations and rejections
Stressors in 40-60 year olds that are most likely to induce suicide
Economic problems
Stressors in >60 year olds that are most likely to induce suicide
Medical illness becomes the most important factor
Most common personality disorder in those who attempt suicide
Borderline personality disorder
All suicide victims w/ personality disorders seem to have Axis 1 problems

95% of cases also include at least of one of what 2 Axis 1 disorders?
Major Depression
Substance abuse disorder
Suicide victims, compared to accident victims, have lower levels of what chemical?
CSF 5-HIAA
(major metabolite of 5-HT)

NOTE: upregulation of 5-HT2A receptors in pts. w/ prev. suicide attempts
Less amounts of what substance is assoc. w/ impulsive behavior?
5-HIAA
(major metabolite of 5-HT)


Low serotonin is assoc. w/ low impulse control
What substances appear to have facilitatory roles when it comes to impulsivity?
DA and NE

Borderline pts. on TCAs often have worsened hostility and paranoia