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Psychiatry pro +1700 > Suicide > Flashcards

Flashcards in Suicide Deck (56)
1

For every suicide, how many attempted suicides are there?

11

2

What is a crisis?

The point in an individual's life situation, when urgent intervention is required to avoid precipitous deterioration of his/her condition

3

What is the most common source of error in the ED with psychiatric concerns?

Overlooking physical conditions as an underlying cause of emotional distress

4

True or false: psychiatric dx usually stay on a patient's chart, even after the true etiology is later confirmed

True

5

What is the usual resulting behavior in a provider, when they are afraid of a patient? What are the consequences of this?

-More restrictive measures than necessary
-Start action to regain autonomy

6

What is the usual resulting behavior in a provider, when they over identify with the patient? What are the consequences of this?

Relaxing of precautions and lack of appropriate response

7

What is the usual resulting behavior in a provider, when they are angry at a patient? What are the consequences of this?

-Over-react and control/punish
-Fear in the patient and decreased self closure

8

What is the usual resulting behavior in a provider, when they are feel any measures they provide for a patient are hopeless? What are the consequences of this?

-passive or slow to intervene
-Lack of appropriate response, pt feels more hopeless

9

What are the common chronic medical condition that usually cause thoughts of suicide?

-AIDS
-TBI
-CA
-Epilepsy/Huntington's
-Spinal cord injuries
-Cardiopulmonary disease

10

What are the three major reasons for suicidal ideation from the internal mental state?

-Feelings of absolute guilt
-Need to escape
-Intolerable emotional states

11

True or false: psychotic patients are more likely to be violent than non-psychotic patients

True

12

True or false: psychotic patients are more likely to be victims of violence, than be perpetrators

True

13

What types of psychotic disorders are more likely to lead to violence?

-Paranoia
-Command hallucinations

14

What type of hallucinations are more likely to lead to violence?

Command hallucinations

15

Which two PDs are particularly prone to violence?

Borderline PD
Antisocial PD

16

What two lobes of the brain that, if injured, lead to violence?

frontal and temporal lobe

17

Is childhood or adolescent aggression more concerning for future violent behavior?

Childhood

18

True or false: a h/o having been victimized leads to a lower incidence of violence in the future

False--risk factor for violence

19

Are males or females a risk factor for violent behavior?

Male

20

What is the triad of symptoms that predicts violent behavior in kids?

-Firesetting
-Cruelty to animals
-enuresis

21

Is a younger or older age a risk factor for violent behavior?

Younger

22

What are the three major questions to ask to assess for violent behavior?

-Thoughts of harming others
-h/o seriously injuring another
-Most violent act ever committed

23

What are the four major steps to take when talking to a potentially violent patient?

1. Multiple communications
2. Alert staff
3. Watch for physical signs and indicators
4. Have all emergency info in place

24

Should you avoid direct eye contact with violent patients?

Yes

25

What should be the character of your voice with violent patients?

Remain calm and speak quietly

26

Where should you be relative to the patient and the door?

Closer to the door, but not blocking it

27

How far should you stand away from a violent patient?

Leg length

28

True or false: it is best to hospitalize all "at risk" patients, in terms of suicide potential

False

29

What is the only reason to psychiatrically hospitalize a patient?

If they're not safe anywhere else

30

What is the major issue with suicide contracts?

Takes away an "out" patients feel that they have

31

What is the single strongest predictor of attempts at suicide?

Prior h/o attempts (even if minor)

32

True or false: personality disorders increase the risk for suicide

True

33

What is the risk of suicide for a patient who lost a parent to suicide before the age of 18?

3x

34

When, relative to the loss of a loved one, are suicides in related patients particularly high?

Anniversary of loss

35

What is a major risk factor for suicides in the adolescent population?

Suicide of a close friend

36

What is the major problem with medication and suicide?

Increases energy and drive to kill themselves

37

Is fantasy/wish to reunite with a deceased loved one a risk factor for suicide?

Yep

38

What happens to regret levels with increasing attempts at suicide?

Decreases regret

39

What are the risk factors for multiple attempts at suicide?

-Poorer social problem solving skills
-Comorbid conditions

40

True or false: patients with multiple attempts at suicide usually stick to the same means

False--often change their method from nonviolent/non lethal to violent/lethal

41

What are the top three methods of completed suicide?

1. Firearms
2. Suffocation
3. Poison

42

What is the top means of attempted suicide (but not completed)?

Overdose

43

Guns in the home = a (__)x increased risk of dying with an attempt of suicide?

5x

44

What are the three key risk factors for suicide by firearm?

-Social isolation
-Ready access to weapon
-Alcohol/substance abuse

45

What is the appropriate approach to a suicidal patient?

-Stay positive
-Manage your own emotional reactions

46

What is the best way to avoid feeling too much empathy towards suicidal patients?

Alternate between suicidal and not

47

Why is it particularly important to obtain prior treatment records in assessing a suicidal patient?

They may not be honest about their past experiences

48

What should be documented with suicidal patients? (4)

-Face-to-face assessment-
-Initial and ongoing assessment of suicidal risk
-Mental status exam
-F/u on d/t recommendations

49

With suicidal patients, you should make the treatment plan consistent with what?

-dx
-dynamics
-suicide risk
-Capacity of pt to comply

50

What is the best way of protecting yourself against a lawsuit with suicidal patients?

Document thinking

51

What are the four major steps in the general approach to suicide risk?

-Elicit information for assessment
-Place info in context of patient
-Determine level of intervention
-Plan the nature and frequency of future reassessments

52

What are the three ways of increasing the protective factors in a patient's life?

-Pt cooperation around safety concerns
-Alliance and other supportive relationships
-Observation or hospitalization

53

What are the two best ways to decrease the strength of risk factors in a suicidal patient?

-Access to weapons, drugs etc.
-Triggering /environmental/ relationships

54

When is hospitalization for a suicidal patient particularly indicated? (4)

-Has no support
-Has a h/o impulsive behavior
-Has a plan and clear intent
-Cannot participate effectively in their own treatment

55

What is the appropriate level of intensity in the response to a suicidal patient?

Parallel the probability of suicide

56

What is the major issue with being too involved in the suicidal patient's life?

Trying to do externally what can only be done internally