Suicide Risk Assessment
Elderly versus Adolescents suicide attempts suicide? - Adolescents have more suicide attempts
200:1 (attempt suicide) compared to 4:1 in elderly
Ethanol Abuse? - Alcohol
Genetic risk of suicide in relatives? Number times increased risk? - 4 fold increased risk
High risk profile for suicide? - - Young, male, white, never married
- Good pre-morbid functioning, deteriorating health
- Post-psychotic depression
- History of substance abuse
- History of suicide attempts
- Hopelessness, fear further deterioration, loss of faith in
treatment
- Social isolation, limited external support, family stress,
recent loss or rejection
- Psychiatric Hospitalization
Highest lethality of suicide? - Hanging85% (> firearm 75%)
How do suicide rates change with age? - Adolescence: age 10-24
- Suicide rates rise sharply
Midlife: age 25-69
- Suicide rates plateau
, Elderly: 70-
- Suicide rates rise again
% of pts who commit suicide have seen a physcian with month of death? - 2/3
% who use alcohol prior to suicide? - 50%
2nd most common psych precursor to suicide? - EtOH
Age Risk? (2) - 15 - 24 and elderly
Chronic versus Fatal illness risk of suicide? - Chronic
Demographics - Race/ethnicity for Suicide - Whites, Native Americans 2x's > Hispanics, African
Americans, & Asians
- Age > 65: Whites, Hispanics, Asian
- Teens/early 20's: Native Americans, African Americans
Depression risk? # times greater - 20x greater
Determination of high intent? (5) - - Taking measures to avoid discovery
- Using more lethal methods
- Physical injuries from attempt
- Suicide note
- Did pt expect to die?
Elderly versus Adolescents suicide attempts suicide? - Adolescents have more suicide attempts
200:1 (attempt suicide) compared to 4:1 in elderly
Ethanol Abuse? - Alcohol
Genetic risk of suicide in relatives? Number times increased risk? - 4 fold increased risk
High risk profile for suicide? - - Young, male, white, never married
- Good pre-morbid functioning, deteriorating health
- Post-psychotic depression
- History of substance abuse
- History of suicide attempts
- Hopelessness, fear further deterioration, loss of faith in
treatment
- Social isolation, limited external support, family stress,
recent loss or rejection
- Psychiatric Hospitalization
Highest lethality of suicide? - Hanging85% (> firearm 75%)
How do suicide rates change with age? - Adolescence: age 10-24
- Suicide rates rise sharply
Midlife: age 25-69
- Suicide rates plateau
, Elderly: 70-
- Suicide rates rise again
% of pts who commit suicide have seen a physcian with month of death? - 2/3
% who use alcohol prior to suicide? - 50%
2nd most common psych precursor to suicide? - EtOH
Age Risk? (2) - 15 - 24 and elderly
Chronic versus Fatal illness risk of suicide? - Chronic
Demographics - Race/ethnicity for Suicide - Whites, Native Americans 2x's > Hispanics, African
Americans, & Asians
- Age > 65: Whites, Hispanics, Asian
- Teens/early 20's: Native Americans, African Americans
Depression risk? # times greater - 20x greater
Determination of high intent? (5) - - Taking measures to avoid discovery
- Using more lethal methods
- Physical injuries from attempt
- Suicide note
- Did pt expect to die?
