Evaluating and Managing Suicide Risk with the Adult Patient

2015 ◽  
Author(s):  
Bruce Bongar ◽  
Glenn Sullivan ◽  
Victoria Kendrick ◽  
Joseph Tomlins
Keyword(s):  
Health Care ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Health Care Professionals ◽  
Suicide Risk ◽  
Suicidal Patient ◽  
Suicide Assessment ◽  
Potential Harm ◽  
The World ◽  
Suicidal Patients

Suicide and suicidal behavior are major medical and social problems in many parts of the world, despite a growing understanding of how to adequately prevent suicide. Many health-care professionals do not have a sufficient knowledge base and the training to provide adequate suicide assessment, nor do they have an understanding of the protocols necessary for management of suicidal patients. Without validated predictive tools to use in cases of suspected suicidal ideation, it is usually left to the clinician to make a decision regarding risk and potential harm. In this chapter we describe how to identify a suicidal patient and the procedures necessary to adequately provide services.

Teaching medical professionals and trainees about adolescent suicide prevention: five key problems

2012 ◽  
Vol 24 (2) ◽  
Author(s):  
Leo Sher
Keyword(s):  
Suicide Prevention ◽  
Suicidal Behavior ◽  
Health Care Professionals ◽  
Suicide Risk ◽  
Adolescent Suicide ◽  
Signs And Symptoms ◽  
Medical Problem ◽  
Warning Signs ◽  
Medical Professionals ◽  
Suicidal Patients

Abstract Predicting and preventing suicide represent very difficult challenges for clinicians. The awareness of adolescent suicide as a major social and medical problem has increased over the past years. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Suicide prevention efforts among adolescents are restricted by the fact that there are five key problems related to the evaluation and management of suicidality in adolescents: 1. Many clinicians underestimate the importance of the problem of adolescent suicidal behavior and underestimate its prevalence. 2. There is a misconception that direct questioning of adolescents about suicidality is sufficient to evaluate suicide risk. 3. Another misconception is that adolescents with non-psychiatric illnesses do not need to be evaluated for suicidality. 4. Many clinicians do not know about or underestimate the role of contagion in adolescent suicidal behavior. 5. There is a mistaken belief that adolescent males are at lower suicide risk than adolescent females. Educating medical professionals and trainees about the warning signs and symptoms of adolescent suicide and providing them with tools to recognize, evaluate, and manage suicidal patients represent a promising approach to adolescent suicide prevention.

The Association Between Racism and Suicidality Among Young Minority Groups: A Systematic Review

2021 ◽  
pp. 104365962110469
Author(s):  
Giorgia Rudes ◽  
Claudia Fantuzzi
Keyword(s):  
Systematic Review ◽  
Health Care Professionals ◽  
Suicide Risk ◽  
Minority Groups ◽  
World Health ◽  
Physical And Mental Health ◽  
Dominant Culture ◽  
The World ◽  
Health Organization ◽  
The Relationship

Introduction: The World Health Organization states that suicide is the second leading cause of death among youngs, and racism has been proven to have detrimental effects on both physical and mental health. These two plagues represent a public health priority, especially for susceptible minorities. Method: This systematic review analyzed 23 studies from multiple database searches, to understand the relationship between racism and suicidality in young minority groups. Results: The review demonstrated the correlation between racism and suicidality with the consequent development of mental disorders. There is strong evidence that the main suicide risk factor is acculturation, interpreted as the assimilation of the dominant culture with the loss of values from one’s cultural background. Discussion: Health care professionals should not underestimate the risk of suicidality associated with racism. Prevention is crucial and it should be implemented from a young age, in schools, through a joint intervention with children and their families, aiming toward integration without acculturation.

Analysis of Suicidal Behavior and Chronicity of Depressive Symptoms in the Presence of Hypovitaminosis D

2021 ◽  
Vol 17 ◽  
Author(s):  
Catarina Magalhães Porto ◽  
Natalia Santos Barbosa da Silva ◽  
Cecília Magalhães Porto Lira ◽  
Rayana Porpino Magalhães ◽  
José Luiz Oliveira Magalhães ◽  
...  
Keyword(s):  
Vitamin D ◽  
Depressive Symptoms ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Hypovitaminosis D ◽  
Serum Levels ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.

Popular diets

2011 ◽  
pp. 213-216
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Potential Harm ◽  
Randomized Controlled ◽  
Scientific Principles

This section is included to help orientate health-care professionals to diets that their patients may initiate or possibly seek advice about. It does not validate their efficacy. For many, evidence of benefit in the form of a randomized controlled trial is not available. However, the concerns, described below, about potential harm resulting from some diets are based on scientific principles....

Appropriate Technology in Primary Health Care: Evolution and Meaning of WHO's Concept

1989 ◽  
Vol 5 (1) ◽  
pp. 103-109 ◽  
Author(s):  
J. Cohen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Appropriate Technology ◽  
World Health ◽  
Health Maintenance ◽  
The Public ◽  
Primary Health ◽  
Careful Scrutiny ◽  
The World ◽  
Definition Of

This article examines the meaning of appropriate technology in the World Health Organization's comprehensive definition of primary care. The author concludes that broad-ranging aspects of health maintenance, such as public health, personal lifestyles, and scientific research, as well as traditional diagnostic and therapeutic practices, need to be subjected to clear and careful scrutiny. It is vital that the results of these technology assessment studies be disseminated as widely as possible to both health care professionals and the public.

A probe in the connection between inflammation, cognition and suicide

2018 ◽  
Vol 32 (4) ◽  
pp. 482-488 ◽  
Author(s):  
Ricardo Cáceda ◽  
W Sue T Griffin ◽  
Pedro L Delgado
Keyword(s):  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Linear Models ◽  
Suicide Attempts ◽  
Limited Data ◽  
Physical Pain ◽  
Reactive Protein ◽  
Depressed Patients ◽  
Downstream Effects ◽  
Suicidal Patients

Background: Increased inflammation is linked to suicide risk. However, it is unclear whether increased inflammation drives suicidal crises or is a trait associated with lifetime suicidal behavior. Limited data exist on the sources of increased inflammation observed in suicidal patients and on its downstream effects. Aims: To examine factors associated with inflammation and with suicidal ideation severity in acutely suicidal depressed patients. Methods: Fifty-two adult depressed patients of both sexes hospitalized for severe suicidal ideation were characterized for suicidality, depression, anxiety, medical comorbidity, psychological and physical pain, impulsivity, verbal fluency, C-reactive protein (CRP) and interleukin (IL) 6. Two generalized linear models were performed with either CRP or suicidal ideation severity as dependent variables. Results: CRP levels were positively associated with age, body mass index (BMI), IL6, current physical pain and number of lifetime suicide attempts. Suicidal ideation severity was not significantly correlated with either CRP or IL6. Suicidal ideation severity was positively associated with female sex, presence of an anxiety disorder, current physical pain, number of lifetime suicide attempts and with delay discounting for medium and large losses. Conclusions: Increased inflammation is not associated with acute suicidal risk, but seems to represent a trait associated with lifetime suicidal behavior.

Suicide

2013 ◽  
Author(s):  
Stacey Freedenthal
Keyword(s):  
Risk Factors ◽  
Social Workers ◽  
Suicide Risk ◽  
Intervention Strategies ◽  
Suicide Assessment ◽  
Effective Prevention ◽  
Prevention And Intervention ◽  
The World ◽  
Suicide Risk Factors

Every year, more people in the world die from suicide than from homicide and wars combined. Efforts to reduce suicide have made several advances. Research has identified numerous suicide risk factors, and, though small in number, effective prevention and intervention strategies have been identified. Social workers are likely to encounter suicidal clients in their work, requiring suicide assessment and intervention skills.

A Model for the Management of Suicidal Behaviour in Primary Care

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Voros ◽  
P. Osvath ◽  
S. Fekete
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Suicidal Behaviour ◽  
Suicide Risk ◽  
Health Care Services ◽  
Warning Signs ◽  
Health Concern ◽  
Care Services ◽  
Suicidal Patients ◽  
Primary Care Professionals

Introduction:Although suicide rates are decreasing in most European countries, suicide is still a major health concern. Despite of the fact, that the vast majority of suicidal patients contacted with health care services before the suicidal act, the doctor-patient meeting is a necessary, but sometimes not sufficient way enough to prevent suicide. Most patients, who commit or attempt suicide, are not regarded as being at high immediate risk at their final contact with health care services.Aims and methods:Based on reviewing the relevant literature and on our previous studies we developed a brief, practical, clinical guideline, which may aid general practitioners and primary care professionals to assess suicide risk and also to manage these patients.Results:We introduce a model for an integrated, regional suicide prevention strategy, which includes recognition, risk assessment and also intervention. The main steps of our model are to recognize warning signs, explore crisis situation and/or psychopathologic symptoms, assess protective and risk factors, estimate suicide risk, plan intervention strategies, and finally manage suicidal patients through the different levels of intervention.Conclusion:In the management of suicidal behaviour the complex stress-diathesis model has to be adjusted by considering biological markers (mental disorders, personality traits) and psycho-social factors (crisis, negative life events, interpersonal conflicts). Only after the assessment of these factors primary care professionals, as ‘gatekeepers’ can manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic facilities in the recognition, treatment and prevention of suicidal behaviour.

scholarly journals COMPORTAMENTO SUICÍDA E ATENÇÃO PRIMÁRIA À SAÚDE

2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Micheli Leal Ferreira ◽  
Mara Ambrosina De Oliveira Vargas ◽  
Jeferson Rodrigues ◽  
Daiane Trentin ◽  
Laura Cavalcanti de Farias Brehmer ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Attempted Suicide ◽  
Primary Health ◽  
Factores De Riesgo ◽  
Suicide Attempted ◽  
Primary Care Professionals

Objetivo: Conhecer as evidências relativas ao comportamento suicida na atenção primária à saúde, em produções científicas nacionais e internacionais. Metodologia: Revisão integrativa da literatura de janeiro de 2012 a abril de 2017. Utilizaram-se os termos: “Suicídio”, “Tentativa de suicídio”, “Ideação suicida” e “Atenção Primária à Saúde” resultando em 35 artigos. Resultados: Predominam estudos com enfoque na avaliação da prevalência de comportamento suicida; na descrição/avaliação da eficácia na prevenção/detecção de pessoas com comportamento suicida; e na identificação do perfil/fatores de risco ou proteção de pessoas com comportamento suicida que utilizaram a atenção primária. Evidenciou a necessidade em estudos com destaque à atenção primária à saúde, principal porta de entrada da pessoa em sofrimento. Conclusão: Uma lacuna importante a ser preenchida é a carência de estudos que enfoquem a identificação/desenvolvimento de estratégias de sensibilização/ capacitação dos profissionais da atenção primária para intervenção/prevenção ao comportamento suicida.DESCRITORES: Suicídio; Tentativa de suicídio; Ideação suicida; Atenção Primária à Saúde.SUICIDAL BEHAVIOR AND PRIMARY HEALTH CARE: AN INTEGRATIVE REVIEWObjective: To know the evidence regarding suicidal behavior in primary health care in national and international scientific productions. Methodology: Integrative review of the literature from January 2012 to April 2017. The terms “Suicide”, “Attempted suicide”, “Suicidal ideation” and “Primary health care” were used, resulting in 35 articles. Results: Predominant studies focus on the evaluation of the prevalence of suicidal behavior; in the description / evaluation of effectiveness in the prevention / detection of people with suicidal behavior; and the identification of the profile / risk factors or protection of people with suicidal behavior who used primary care. It evidenced the need in studies with emphasis on primary health care, the main entry point of the suffering person. Conclusion: An important gap to be filled is the lack of studies that focus on the identification / development of awareness strategies / training of primary care professionals for intervention / prevention of suicidal behavior.Descriptors: Suicide; Attempted suicide; Suicidal ideation; Primary Health Care.COMPORTAMIENTO SUICIDIO Y ATENCIÓN PRIMARIA A LA SALUD: UNA REVISIÓN INTEGRATIVAObjetivo: Conocer las evidencias relativas al comportamiento suicida en la atención primaria a la salud, en producciones científicas nacionales e internacionales. Metodología: Revisión integrativa de la literatura de enero de 2012 a abril de 2017. Se utilizaron los términos: “Suicidio”, “Tentativa de suicidio”, “Ideación suicida” y “Atención Primaria a la Salud” resultando en 35 artículos. Resultados: Predominan estudios con enfoque en la evaluación de la prevalencia de comportamiento suicida; en la descripción / evaluación de la eficacia en la prevención / detección de personas con comportamiento suicida; y en la identificación del perfil / factores de riesgo o protección de personas con comportamiento suicida que utilizaron la atención primaria. Evidenció la necesidad en estudios con destaque a la atención primaria a la salud, principal puerta de entrada de la persona en sufrimiento. Conclusión: Una laguna importante a ser llenada es la carencia de estudios que enfoquen la identificación / desarrollo de estrategias de sensibilización / capacitación de los profesionales de la atención primaria para intervención / prevención al comportamiento suicida.Descriptores: Suicidio; Tentativa de Suicidio; Idea Suicida; Atención Primaria a la Salud.

The Suicidal Crisis

2017 ◽  
Author(s):  
Igor Galynker
Keyword(s):  
Risk Assessment ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Stressful Life Events ◽  
Suicidal Patient ◽  
Short Term ◽  
Clinical Value ◽  
Reference Guide ◽  
Case Vignettes ◽  
Suicidal Crisis

One of the most difficult determinations a psychiatrist makes is whether the chronically suicidal patient is at risk for suicide in the immediate future. The Suicidal Narrative is the first book to help clinicians evaluate the risk of imminent suicidal behavior. The book describes a theoretical framework for a systematic and comprehensive assessment of short-term suicide risk and also describes practical ways of conducting risk assessment interviews in different settings. The book is based on the narrative crisis model of suicide, which posits that individuals with trait vulnerability for suicide attempt suicide after they develop the suicide crisis syndrome when they feel that their life narrative has no acceptable future. This book first reviews current models of suicidal behavior and introduces the narrative crisis model of suicide. Next, it provides a comprehensive description of trait vulnerabilities followed by a discussion of stressful life events that may increase short-term suicide risk. The book’s core introduces the key concepts of the narrative crisis model of suicide—the suicidal narrative and suicide crisis syndrome—and addresses the clinical value of clinicians’ emotional responses to suicidal patients. Finally, the book provides practical guidance for conducting short-term suicide risk assessment and introduces current approaches to suicide risk reduction. The Suicidal Narrative is designed as a textbook and reference guide. The book contains more than 50 clinical case vignettes, detailed examples of risk assessment interviews, as well as test cases for self-assessment.

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