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Suicide

Irene C. Coletsos, MD and Harold J. Bursztajn, MD Reviewed 06/2018
 


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 suicid...

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...

TREATMENT

GENERAL MEASURES

  • Patients expressing active suicidal thoughts or who made an attempt require immediate evaluation for risk factors, mental status, and capacity (to determine if they are able/...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

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

  • Educate family members and other close contacts/c...

REFERENCES

1
Jollant F, Bellivier F, Leboyer M, et al. Impaired decision making in suicide attempters. Am J Psychiatry.  2005;162(2):304–310. [View Abstract on OvidMedline]
2
Brown GK, Ten Have T, ...

ADDITIONAL READING

  • Bryan CJ, Jennings KW, Jobes DA, et al. Understanding and preventing military suicide. Arch Suicide Res.  2012;16(2):95–110. [View Abstract on OvidMedline]

  • Gutheil TG, Bursztaj...

CODES

ICD10

  • R45.851 Suicidal ideations

  • T14.91 Suicide attempt

  • Z91.5 Personal history of self-harm

ICD9

  • V62.84 Suicidal ideation

  • 300.9 Unspecified nonpsychotic mental disorder

SNOMED

  • 44301001 Suicide (disorder...

CLINICAL PEARLS

  • Key preventative measure is to listen to a patient and take steps to keep him or her safe. This could include immediate hospitalization. Questions to explore include, “Are you thinking...

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