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Flashcards in Assessment of Dangerousness Deck (24)
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0
Q

Risk factors for suicide

A
major depression (accounts for 50%)
alcoholism and drug dependence (50%)
schizophrenia
personality disorders
medical risk factors
family and genetic factors
social risk factors
1
Q

how often are suicides successful?

A

once out of every 8-10 attempts

2
Q

age most likely to commit suicide

A

15-24 years

>60 years

3
Q

gender

A

women 3x more likely to attempt

men 3x more likely to complete

4
Q

biological markers

A

decreased CSF level of 5HT and 5-HIAA

HPA axis hyperactivity

5
Q

treatment for decrease risk of suicide

A

lithium
clozapine
ECT

6
Q

not proven to decrease overall suicide risk

A

SSRIs

7
Q

even a week’s supply of some antidepressants

A

can be lethal

8
Q

4 things to monitor

A

intentionality- what is the level of expressed intention?
lethality- does the patient have a plans? How lethal is the plan?
Means- does the patient have th emeans to carry out their plan?
Viability- What is the ability of the patient to accept help and hope?

9
Q

Tarasoff Warning

A

duty to warn intended victim

duty to protect intended victim

10
Q

aggression

A

overt behavior involving intent to inflict noxious stimulation or to behave destructively towards another organism

may be impulsive or premediated

11
Q

agitation

A

state of poorly organized and aimless psychmotor activity- stems from a state of physical and mental unease

emergency

12
Q

red flags for likely medical cause

A

new onset agitation ina dult over age 45 with no psych histroy
not consistent with known psych history
abnormal vital signs
abnormal PE findings
signs/sx of drug/alch intox
signs/sx of drug/alch withdrawal
confusion, disorientation, deficits in attn and cognition

13
Q

cycles of de-escalation

A

listen to patient
find a way to agree with/validate patient
state what you want the patient to do

14
Q

a drug is considered a restraint when

A

used to restrict behavior or movement and is not a standrad treatment or dosage for condition

15
Q

three types of drugs studied for agitation managament

A

1st generation antipsychotics- haldo
2nd generation antispychotics- dopamine-5ht antagonists (risperidone,etc)-dopamine antagonism
benzos

16
Q

benzos are not preferred when

A

agitation is secondary to psychosis- will just sedate and not address underlying cause, but if agitation is unknown and no psychosis- benzos are considerd a first line agent

17
Q

for acute agitation

A

antihistamine
benzos
nonbenzo anxiolytuics
neuroleptics

18
Q

anxiety treatmetn

A

GABA agonist dampensens CNS response; bblockers symp resonse to stress

19
Q

fear disorganization frankpsychosis delirum

A

DA blockade

20
Q

tendency towards violence

A

substance abusing patient
psychaitric agitated patient
delirious patient

21
Q

treatment substnace abusing

A

destimlate
monitor and support
dopamine antagonism

22
Q

EtOH withdrawal

A

thiamaine, folate, MVI
benzos
dopamine antagonism

23
Q

delerious patient treatment

A

treat underlying organic etiology
minimize anticholinergic agents and benzos
dopamine antag