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.
*Common themes in suicide :-
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
*Epidemiology :-
-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
ز hopelessness and helplessness ering with feeling of hoperforming the action never intended to die by act
*Risk Factor of suicide :-
-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.
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
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
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.