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:
Suicide
-Intentional termination of life
-It is common cause of death among psychiatric patient
-Suicidal gesture is attempted Suicide where the person performing
the action never intended to die by act.
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Common themes in suicide
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1-Crisis that cause intense suffering with feeling of hopelessness and
helplessness.
2-Conflict between intolerable stress and survival.
3-Narrowing of person perceived options.
4-Wish to escape rather than going-toward
5-Often wishing to punish self and or punishing significant with guilt
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Epidemiology
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-Suicide is among top (10) cause of death
-The official suicidal rate is 10/100.000 population/year
-Male to female ratio is 6:3
-General world ratio range from 5-30 /100.000
-1million death due to suicide in the world
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Risk Factor of suicide
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-Age > 40 year.
-Male gender.
-Staying single.
-Previous suicide attempt.
-Depression (risk about 25 time than usual)
●Presence of guilt, accusation, nihilistic.
●Risk usually higher in the beginning or to word the end of depressive
episode.
●Increase risk in first week after discharge from psychiatric unit
-Suicidal preoccupation(for example a written suicide note and details
plan of suicide).
-Alcohol or drug dependence.
-Sever disability, painful untreatable syndrome.
-Recent serous loss or major stressful event.
-Social isolation.
-Higher degree of impulsivity.
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Examples Of Risk And Protective Factor For Suicide
Social
Psychological
factor
Biological
factor
Factors
-Poor social
support
-Unemployment
-Early
childhood
trauma
-Personality trail
Genetic factor
male gender
older age
Predisposing
-Finicial
difficult
-Easy
availability
lethal mean
-Separation
from spouse
-Hopelessness
-Worthlessness
-Discontinuation
of
antidepressant
-Psychiatric
disorder
Precipitating
-Poor social
support
-Poor self
esteem
-Alcohol and
drug abuse
Perpetuating
-Children, elderly parent and moral values
-Good engagement with treatment
Protective
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Management of suicide
-Once suicide committed it is obviously no longer treatable. So we have :
-Preventing acts
●Establish of suicide prevention center
●Crisis intervention center
●Psychiatric emergency service
●Medical emergency center
●Social welfare center like
-samaritan
-sanjivini
-miatri
-home to patients
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:
Importat preventive measures of suicide
1-Take all suicidal threats, gesture, seriously.
2-Psychiatrist should qualify seriousness of situation (proper risk
assessment).
3-Acute psychiatric emergencies interview.
4-Councelling and Guidance.
●
to deal with attempted suicide.
●
to deal with life stressor, teach patient to cope with.
5-Treatment of psychiatric disorders for patient with major depressive
disorder with suicidal risk, also treatment of suicide associate
psychoses.
Common Misconception About Suicide
Facts
Misconception
Nearly 80/person who
commit suicide give definite
warning and/or clue about
their suicide.
1-people who talk about
suicide, don't commit suicide.
2-Suicide happen without
warning.
Most suicidal undecided
about dying or Living.
3-Suicidal persons are fully
intent or dying.
Suicidal person is suicidal for
only a limited period of time
4-Once person is suicidal he is
suicidal forever.
Although suicide common
among depressive or
psychotic but patient is not
necessarily ill
5-All suicidal are ill or
psychotic.
