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Suicide

Harold J. Bursztajn, MD and Irene Coletsos, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Suicide and attempted suicide are significant causes of morbidity and mortality. 

EPIDEMIOLOGY

  • Predominant sex

    • Women attempt suicide 1.5 times more often than men. Men complete suicide ...

DIAGNOSIS

HISTORY

  • Depressed patients should be asked about suicidal ideation and a potential plan:

    • “Have you ever felt that life isn’t worth living? Do you ever wish you could go to sleep and not wake u...

TREATMENT

GENERAL MEASURES

  • Patients expressing active suicidal thoughts or who made an attempt require immediate evaluation for risk factors and a formal psychiatric consultation.

  • Cognitive therapy decr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Increase monitoring at the beginning of treatment, when changing medications, and after hospital discharge.

  • Educate family and other close contac...

REFERENCES

1
Rabin CR. US Suicides Reduced Overall in 2020 But May Have Risen Among People of Color. www.NYTimes.com/2021/04/15/health/coronavirus.suicide-cdc.html. Updated September 10, 2021. Accessed...

ADDITIONAL READING

Gutheil TG, Bursztajn H, Brodsky A. The multidimensional assessment of dangerousness: competence assessment in patient care and liability prevention. Bull Am Ac...

CODES

ICD10

  • R45.851 Suicidal ideations

  • T14.91 Suicide attempt

  • Z91.5 Personal history of self-harm

SNOMED

  • 44301001 Suicide (disorder)

  • 82313006 suicide attempt (event)

  • 267073005 Suicidal (finding)

  • 6471006 Suici...

CLINICAL PEARLS

  • Key preventative measure is to listen to patients and take steps to keep them safe. This could include immediate hospitalization.

  • Clozapine lithium and CBT are associated with a reduct...

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