SUICIDE – PSYCHIATRIC INPUTS
Risk factor for suicide in depression are all EXCEPT:
| A | Female | |
| B | Male > 45 | |
| C | Child with conduct disorder | |
| D | Family |
Risk factor for suicide in depression are all EXCEPT:
| A | Female | |
| B | Male > 45 | |
| C | Child with conduct disorder | |
| D | Family |
Female REF: Kaplan and sadock’s synopsis in psychiatry 10th ed p. 529
Risk factors of suicide in depression are:
- At end( involutional) or beginning of depression
- Mood disorders , personality disorders , psychosis , hypochondriac
- >45yrs male, unemployed, single, divorced, chronically ill, widowed, recently bereaved
- Family history
A 60 year male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not through hot do go about it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him?
| A |
Antipsychotic + Anti depressant |
|
| B |
Antidepressant with cognitive behavioural therapy |
|
| C |
Guidance & recounselling with guru+Anti depressant |
|
| D |
Anti depressant alone |
A 60 year male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not through hot do go about it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him?
| A |
Antipsychotic + Anti depressant |
|
| B |
Antidepressant with cognitive behavioural therapy |
|
| C |
Guidance & recounselling with guru+Anti depressant |
|
| D |
Anti depressant alone |
A i.e. Antipsychotic + Anti depressant
The patient is presenting with features of depression, hypochondrial preoccupation & delusional guilt suggesting the diagnosis of depression with psychotic features (i.e. psychotic depression). It should be managed with a combination of antipsychotic (SNRIs or TCA rather than SSRI) and antidepressantQ. ECT is an alternative perhaps more effective than pharmacotherapy.
Suicide is most common in ‑
| A |
Depression |
|
| B |
Alcohol dependence |
|
| C |
Dementia |
|
| D |
Schizophrenia |
Suicide is most common in ‑
| A |
Depression |
|
| B |
Alcohol dependence |
|
| C |
Dementia |
|
| D |
Schizophrenia |
Ans. is ‘a’ i.e., Depression
Causes/Risk factors for suicide
- Psychiatric disorders : – Depression (most common), alcoholism (2nd mc), Drug/Substance dependence, Schizophrenia, Dementia.
- Physical illness : – Cancer, AIDS, Multiple sclerosis, Head trauma.
- Psychosocial factors : – Failure in love, marital difficulties, family dispute, illegitimate pregnancy.
- Biological factors : – Decrease in serotonin
- Other – Male sex, Age > 40 years, Single (Unmarried, divorced or widowed), previous suicide attempt, social isolation.
