Suicide |
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| 2007-12-24 | No history |  | Add My version | |
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| Mind map Suicide (from MedMaps.co.uk) - the online mind map resource for medical students and doctors. Psychiatry. Medicine. | |
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Suicide
Characteristics
Suicidal behaviour
Continuum
Ideations
Suicidal gestures
Parasuicide
Risk taking
Suicide attempts
Suicide completion
Risk factors
All interact between each other
difficult to predict
Psychiatry
Psychiatric co-morbidities
up to 90%
Main
Depression
Bipolar
Schizophrenia
Sleep disorder
terminal insomnia
Self-harm Hx
Biology
White
Male
6:1
complete suicide
3:1
suicide attempts
>45y
Physical co-morbidities
chronic
Family Hx
Chronic illness
Medical
Neurotransmission anomalies
Low 5-HIAA
serotonin byproduct
Low serotonin
5-HT
less serotonin transporters
smaller serotonergic cells
more post-synaptic 5-HT receptors
Personality
Sociopathic personality
Borderline personality
Cognitive rigidity
Sociology
Isolation
Divorced
Alcohol xs
Financial
Unemployed
Honour
Social class I or V
Prevalence
10 million / year
increasing
Management
Investigations
paracetamol levels
Treatment
ECT
short term
faster than antidepressants
Lithium
Bipolar and unipolar disorder
TCAs
better than SSRIs for suicide prevention
Toxic in overdose
SSRIs
fluoxetine
30% have no effect
Antipsychotics
Clozapine
agranulocytosis
cardiomyopathy
5 steps
Contract of help
Family involvement
Problem-solving
Support
Follow-up
Differential
Self-harm
manipulative behaviour
History
Intro & Rapport
Trigger?
circumstances
Intentions
past
present
Symptoms
Depression?
Psychosis?
Suicidal risk
Previous attempts?
view of future?
Regret being alive?
Social support?
Alcohol and drugs
Mx, Rx, Psych Hx
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