Download suicide

Eman abahussain, MD
clinicat Assistant professer,
Consultant Psychiatrist
King Saud University
College of Medicine
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intentional Self killing
Over 800,000 people die due to suicide every year
and there are many more who attempt suicide
Suicide occurs throughout the life span and was
the second leading cause of death among 15-29
year olds globally in 2012
in 2012. Suicide accounted for 1.4% of all deaths
worldwide, making it the 15th leading cause.
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Over 90% of suicide victims have a diagnosable
psychiatric disorder—over half have a
depressive disorder
Suicidal behaviors are the most common
psychiatric emergency
In Saudi Arabia no data are available
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firearm 61% in men
and 37% in women
Self-poisoning. around
30% of global suicides
more common in
women
hanging, cutting,
burning , jumping from
high places etc
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Psychiatric disorders:
Depressive disorder
Substance abuse.
Bipolar disorder
Schizophrenia
Personality disorder
Chronic medical illness
Family Hx. Of Affective Illness or suicide
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Risk of suicide increase in the weeks following
psychiatric contact after beginning of treatment
Previous Suicidal Attempts
impulsiveness
History of childhood abuse (physical, verbal, or
sexual)
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Male
Age >45 and adolescence
Divorced ,widow>single>married
living alone
unemployed.
Recent bereavement, separation, loss.
Financial problems
Certain occupations: police officers, physicians
Poor social support
Stressful life events
migration –incarceration
Lower rates among Muslims, Jews and Catholics,
presumably due to religious prohibition
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Freud: aggression turned inward
Escape from rage
Guilt; self-punishment or Hopelessness.
Rebirth or reunion fantasies
Control over a relationship
Revenge
Durkheim theory:
three social categories:
 egotistic suicide: occurred in individuals who
lost their sense of integration with their social
group
 Altruistic suicide: ###sacrificed their lives for
the good of the social group
 Anomic suicide:##with disturbed integration
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History of previous attempts
Depression
Alcohol or drug abuse
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33-50% with schizophrenia will attempt suicide
Approximately 10% with schizophrenia die by
suicide
Gender: equal attempt ratio, more men die by
suicide
Risk factors :
Isolation (single, living alone, unemployed)
Substance abuse
50% have made previous suicide attempt
Small % because of hallucinations or delusions
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Young men early in the course of illness.
Depressive symptoms(75%)
hopelessness and helplessness
After resolution of an acute psychotic
exacerbation
Days, weeks, months after hospitalization
Persons with more “insight” thought to be at
higher risk of suicide
History
 Mental state
 presence of risk factors
 Careful evaluation of:
thoughts wither life is not worth
living
Wish to be dead
non specific Suicidal thoughts.
Suicidal thought with intent to act.
Suicidal thoughts with specific Plan
Preparatory Acts (Suicidal note )
Actual attempt
Lethality of the method
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Frequency, Duration of suicidal thoughts
Controllability.
Deterrents.
Reasons for Ideation
Presence of homicidal ideation
Short term:
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Detect high risk group.
Admission: psychiatric vs. medical wards
Instructions to nurses(level of observation, policy for
visitors)
Management of medical problems
Involvement of family
Treat psychiatric disorder
Manage social stress
Psychological treatments
Long-term:
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Maintenance of treatment
OPD follow-up
Social support
easy contact to service(crisis centers and
hotlines)
Watch of relapse
Parasuicide or
attempted suicide or
deliberate self harm
An act of self damage carried out with
destructive intent without the will to
finish one’s life.
Causes:- personality disorder(impulsive behavior,
attention seeking behavior)
- alcoholism.
- situational crisis.
- not planned act.
- no intention to be dead
- female
-Young
-Personality problem
- previous attempts.
-non lethal method
- psychosocial stresses.
- broken home background
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Drug over dose
Self injury: laceration of wrist
jumping
- assessment of physical seriousness
- assessment for Suicide Risk Factor.
- treatment of any Psychiatric Illness.
- psychotherapy.
-problem solving and counseling.
Thank you