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11 Cards in this Set

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suicide is the 3rd leading cause of death in persons age ...
15-24
A 78 year-old white male, recently widowed, comes to your office complaining of insomnia. Further questioning reveals that the patient is feeling depressed and hopeless. He tells you he has “no reason to live” since his wife died. He started drinking whiskey to help him sleep but now he is drinking “more than he should”. His only son and grandchildren live in another state.

what are his risk factors for suicide?
white male

late age

recent loss

substance abuse

depression
give the demographic risk factors for suicide:

age
gender
race
marital status
religion
occupation
Age – elderly at highest risk for completed suicide

Gender – males at higher risk than females for completed suicide (more women will try)

Race – white, Native American at highest risk

Marital status – single, widowed, divorced

Religion – Protestant, Jewish

Occupation – professionals - especially physicians; unemployed
what two psychiatric disorders have increase rates for completed suicide?
MDD 15%

Substance Related Disorders 15%
What are 2 of the biggest risk factors for suicide?
History of previous suicide attempt!
Family history of suicide

others:
Feelings of hopelessness
Suicidal ideation, plan for suicide
Access to firearms
Stressful life events, recent loss
Lack of social support, lives alone
Severe anxiety, panic attacks
Insomnia or lack of sleep
Chronic or terminal illness (e.g., AIDS, cancer)
Prolonged pain, loss of function, disfigurement
what is Parasuicidal Behavior?

*
Term that describes persons who engage in self harm (e.g., cutting the skin) without the expectation of dying.

Some are malingering – seeking admission to hospital to avoid situations such as incarceration

Others want attention from significant others
10% go on to complete suicide

More often: female; low lethality; <35 yr. old; high expectation of rescue

Personality disorder, adjustment disorder, substance abuse common
when should you try to commit someone
imminent risk to self or others

acutely psychotic/manic

cant take care of themselves
15,000 homicides
2nd leading cause of death in ages
15-24
Static Risk Factors: Demographic for violence:

age
gender
SEC
Age
Risk increased in teens to early 20’s
Increased violence among those > 70 (esp. if have dementia)

Gender
Men 3 times more likely than women

Socioeconomic status
Lower SES associated with increased risk
Research with higher SES not extensive
what is the greatest risk of violence?
Substance abuse

in patients with or without mental illness substantially increases risk
what is the single best predictor of violence?
Previous history of violence = single best predictor