Suicidality completed including suicide and attempted suicide. Thoughts on and plans for a Siuzid be described as suicidal ideations.
The completed suicide is a suicidal action that leads to death. A suicide attempt is a non-lethal, directed against themselves, potentially damaging action that will lead to death. A suicide attempt may or may not cause injury. A nichtsuizidale self-injury (NSSI) is a self-inflicted act that causes pain or superficial damage, but does not intend to die. (See also the American Psychiatric Association’s Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors.)
Suicidality completed including suicide and attempted suicide. Thoughts on and plans for a Siuzid be described as suicidal ideations. The completed suicide is a suicidal action that leads to death. A suicide attempt is a non-lethal, directed against themselves, potentially damaging action that will lead to death. A suicide attempt may or may not cause injury. A nichtsuizidale self-injury (NSSI) is a self-inflicted act that causes pain or superficial damage, but does not intend to die. (See also the American Psychiatric Association’s Practice Guideline for the Assessment and Treatment of Patients With Suicidal Behaviors.) Epidemiology Statistics on suicidal behavior are mainly based on death certificates and coroner’s reports and underestimate the true incidence. To provide more reliable information, the CDC, the National Violent Death Reporting System (NVDRs) established; it is a system of states that collects facts from different sources to each violent incident in order to provide a better understanding of the causes of violent deaths (homicides and suicides). The NVDRs is currently available in 32 states. In the United States provides suicide is the tenth leading cause of death, with a mortality rate of 12.6 / 100,000 and nearly 41,000 completed suicides in 2010. The cause of death it counts as follows: 2. among people aged 25 to 34 years under the third people aged 10-24 fourth among people aged 35 to 64, the age group with the highest suicide rate is now the 45 to 64 age group as a result of a significant increase lately). Why does this rate has increased, is unknown; However, the following factors could have contributed to this: Years ago, as a teenager, there was this group a higher rate of depression than in older groups, and researchers predict that the suicide rate is rising with age. This rate includes the increased number of suicide among members of the military and in veterans (20% of suicides belong to this group). This rate may reflect the increased abuse of prescription and non-prescription medicines and a response to the poor economic situation. In recent years, the suicide rate among young people has declined again after a decade of constant rising, but only to rise again again. At all ages, death is more common in women than in men by suicide; the ratio is about 4: 1. The reasons are unclear, but possible explanations include: men seem to seek less help when they are desperate. Men have a higher prevalence of alcohol and drug abuse, which leads to suicidal tendencies. Men are more aggressive and use lethal means, if they take a suicide attempt. The number of suicides in men includes the suicides in the military and veterans who have a higher percentage of men than women. According to estimates every year one million people attempt suicide. In any completed suicide are 15 to 20 suicide attempts. Many people make repeated attempts. Only 5-10% of people who attempt suicide, eventually die by it; but ends with the a fatal four suicide attempts elders. Women make suicide attempts 2 to 3 times more likely than men in girls aged 15-19 years, compared with a test at the boy the same age, give 100 attempts. Approximately one in six people who commit suicide, leaving behind a suicide note. The content can shed light on the reasons for the suicide (including mental disorder). Copycat suicides or contagion effects account for about 10% of suicides. Group suicides are extremely rare, as are murders / suicides. Rarely people commit an act (eg. As to draw a weapon), which force the law enforcement authorities to kill-called. Suicide by police. Etiology Suicidal behavior arises usually from the interaction of several factors. The most important treatable risk factor for suicide is depression, the duration of an episode of depression is the strongest predictor of suicide. Although suicides seem to be more common when intense fear is part of a depression or bipolar depression. The risk of suicidal thoughts and suicide attempts may increase after start antidepressants (Suicidal behavior: depression treatment and suicide risk and Depression in Children and Adolescents: suicide risk and antidepressants). Other risk factors for suicide include: Most other major psychiatric disorders use of alcohol and drugs Former suicide attempts serious physical illnesses, particularly in the elderly personality disorders unemployment and economic decline Traumatic experiences in childhood family history of suicide and / or mental disorders (risk factors and warning signs of suicide.) death by suicide is more common in people with a mental disorder than among age and sex matched controls. Some people with schizophrenia commit suicide, sometimes due to a depression for these people are vulnerable. The suicide method can be bizarre and violent. Suicide attempts are more common with these people than previously thought. Alcohol and drugs may enhance disinhibition and impulsivity while worse-a sentiment potentially deadly combination. About 30% of people who commit a suicide attempt have previously consumed alcohol, and about half of them were intoxicated at the time. Alcohol addicts have an increased risk of suicide, even when they are sober. Heavy, especially chronic and painful physical diseases contribute to about 20% of suicides among the elderly. People with a personality disorder are prone to suicide-this applies v. a. for emotionally immature people with borderline or antisocial personality disorder because they have only a low frustration tolerance and react impulsively to stress with violence and aggression. Certain social factors (eg. As problems with sexual partners, bullying, recent arrest, conflicts with the law) appear to be associated with suicide. After such events, suicide is often the last resort for those already desperate people. Traumatic childhood experiences, particularly the burden of sexual or physical abuse or parental deprivation, related to tried and possibly completed suicides. Suicide can be found in families, so that a family history of suicide, attempted suicide or mental disorders associated with an increased risk of suicide is connected in susceptible people. Methods The choice of suicide methods depends on many things, incl. Cultural factors, the availability of funds and the seriousness of intent. Some methods (eg. As a jump from a great height) make survival virtually impossible, whereas others (eg. As the ingestion of substances) may accept a rescue. But can be derived from choosing a method that then it does not lead to death, not conclude that the intention was less serious. A bizarre method suggests an underlying psychosis. The intake of substances is the method that is used in suicide attempts most often. Violent methods such as shooting and hanging are rare in attempted suicides. Some methods, like driving into an abyss can contaminate other people. When completed suicides use firearms Men most frequently (56%), followed by hanging, poisoning, jumps into the deep and stab wounds / lacerations. Women poisoning most often (37%), followed by firearms, hanging, jumping into the deep and drowning. Measures An employee in health, any suicidal ideation foresees in a patient who is obliged by law to inform the competent authority for intervention. If you neglect it may be liable to prosecution. Suicidal patients may be left only alone if they are in a safe environment. You should by trained personnel (eg. As ambulance, police) in a protected environment (often a psychiatric facility) will be spent. Each suicidal act, whether expressed intention or attempt must be taken seriously. Every patient with a life-threatening self-harm physical injury must be assessed and treated. After confirming an overdose of a potentially fatal substance measures will be taken immediately to prevent the absorption and accelerate elimination from the body to administer any available antidote and provide supportive care (General principles poisoning: therapy). The initial examination can be done by a medical professional who is trained in assessing and dealing with suicidal behavior. However, all patients need a psychiatric evaluation as soon as possible. It must be decided whether the patients need to be admitted and whether coercive or fixation is required. Patients with a psychotic disorder and some patients with severe depression and unresolved crises should be referred to a psychiatric ward. Patients with manifestations of medical disorders that may cause confusion (eg. As delirium, seizures, fever), may need to be transferred to a medical station with adequate suicide preventive measures. After a suicide attempt, the patient denies u. U. any problems because of the severe depression that led to the suicidal act, a short-term improvement in sentiment can follow. Nevertheless, the risk of later completed suicide remains high, if the patient’s disorder is not treated. The psychiatric assessment identified some of the problems that have contributed to the suicide attempt, and helps the doctor to create an appropriate treatment plan. This consists of the following components: construction of a harmonious relationship understanding of the suicide attempt, his background, the events before and the circumstances under which it took place inquiring of the symptoms of mental disorders associated with suicide Full survey of the mental status of the patient, with particular emphasis on the identification of depression, anxiety, agitation, panic attacks, severe insomnia, other mental disorders and alcohol or drug / drug abuse (many of these problems require in addition to crisis intervention specific treatment) In-depth understanding of the personal and family relationships, which are often relevant to the suicide attempt are questioning close family members and friends questions about the presence of a firearm (in the house, except in Florida where such investi chung is prohibited by law) contacting the physician preventing prevention requires the identification of persons at risk and initiation of appropriate interventions (see table: risk factors and warning signs of suicide). Risk factors and warning signs of suicide type specific factors Demographics Male age 45-64 Social situation personally significant anniversaries unemployment or financial difficulties, v. a. if they lead to a drastic decline in living standards, recent separation, divorce or widowhood Recent arrest or Konfikt with the law Social isolation with actual or imagined apathetic attitude of relatives or friends history of suicidality Former suicide attempt forging detailed plans for suicide, taking steps to implementation of the plan (procurement of a gun, pills) and precautions to avoid detection family history of suicide or mental disorder Clinical Depressive illness, especially at the beginning Strong agitation, restlessness and anxiety with severe insomnia Ausgepräg te guilt, feelings of inadequacy and hopelessness; to be feeling a burden to others (depression); Self-abasement; nihilistic delusion delusion or almost delusional belief (eg., cancer, heart disease, sexually transmitted disease) to have a physical illness, or other delusions (z. B. poverty) hallucinations with imperative character Impulsive, hostile personality a chronic, painful or disabling physical illness, v. a. in formerly healthy patient substance use alcohol or drug abuse (including abuse of prescription drugs), especially if the recent use has increased medication use, which can contribute to suicidal behavior (eg. as may be abrupt discontinuation of paroxetine and certain other antidepressants cause increased depression and anxiety, which in turn increases the risk of suicidal behavior) Although some attempted or completed suicides are even people close to surprising and shocking, there may have been clear warnings to family members, friends or medical professionals. These warnings are often explicitly when patients about actually discuss their plans or suddenly put her will or change. However, the warnings may also be less evident when patients make up about remarks about the fact that they had nothing for which it is worth living for, or that they were better off dead. On average GP will face in their practice annually with ? 6 potentially suicidal people. About 77% of people who die by suicide have seen a doctor in the previous year, and about 32% were preceded year for treatment to a psychologist or psychiatrist. As difficult and painful physical illness, substance abuse and mental disorders (v. A. Depression) often play a role in suicide, the detection of these risk factors and the initiation of appropriate treatment are important contributions that can make suicide prevention a doctor. Any patient with a Deperssion should be asked immediately after Suizididaetionen. The fear that such a question could bring the patient only on sebstzerstörerische thoughts is without foundation. The question helps to get a clearer picture of the depth of the depression to the doctor, it encourages a constructive conversation and conveys to the patient that the physician perceives its deep despair and hopelessness. (Z. B. notified by phone, they are about to take a lethal dose of a drug or threatening to jump from a great height) Even people who threaten their imminent suicide can somehow have the desire to go on living. The doctor or other person to whom they turn for help with the request must support this desire in life. Psychiatric emergency help for suicidal people involves the following: building a relationship and open communication with them questions about current and previous psychiatric care and for drugs that are currently being taken help in resolving the problem that caused the crisis offering constructive help with the problem of the beginning the treatment of the underlying mental disorder fastest possible transfer to a suitable place for the follow-up release of low-risk patients in the company of a loved one or a dedicated and sympathetic friend providing this phone number for the patient as a lifeline: + 1-800-273- TALK (8255) depression treatment and suicide risk, the combination of antidepressants and a proven Kurzzeitp sychotherapie is the ideal treatment of depression. People with depression have a significant suicide risk and should be carefully monitored for suicidal behavior and suicidal ideations. The suicide risk may be increased at the beginning of antidepressant treatment when the psychomotor retardation and indecisiveness are improved, the depressed mood but still persists. scheduled to be antidepressants or dosages increased, some patients experience Agiertiertheit, anxiety and increased depression, which may increase suicidal tendencies. Recent public health warnings about the possible association between the use of antidepressants (especially Paotexine) and suicidal ideations and suicide attempts in children, adolescents and young adults have a significant decrease (> 20%) of prescriptions of antidepressants to these groups out. However, the suicide rate among young people in the same period increased by 14%. Thus, these warnings have advised against the drug depression treatment, temporarily may lead to more, not fewer deaths from suicide. Taken together, these results suggest that the best approach is to promote the treatment, but with appropriate precautions such as delivery of antidepressants in sublethal amounts frequent visits to the start of treatment issuing a clear warning to patients and relatives and caregivers, with respect. Deteriorating symptoms or suicidal thoughts to be vigilant instruction to patients, relatives and partners to communicate immediately the prescriber or elsewhere to seek care if the symptoms worsen or thoughts of suicide occur impact of suicide any suicidal act has on everyone involved a deep emotional impact. Doctor, family members and friends can cherish guilt, shame and remorse because they have not prevented a suicide, but also feel anger towards the deceased and other persons. The doctor can offer the families and friends of the deceased valuable resource for people living with their guilt and grief feelings. Medical euthanasia physician assisted suicide (formerly assisted suicide) refers to the medical care for people who want to end their lives. It is controversial and legal in only three states (Oregon, Washington, Montana, Vermont, California); it is possible only if the rules are well prepared for their application. Nevertheless, it is possible that patients respond with painful, debilitating and greatly nichtbehandelbaren diseases their doctor it. Medical euthanasia can provide doctors with difficult ethical questions.