Suicide Prevention

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Overview

Classification

Epidemiology and Demographics

Risk Factors

Screening

Physical Examination

Laboratory Findings

Psychiatric evaluation

Treatment

Medical Therapy

Psychotherapy

Pharmacotherapy

Prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief:  Aditya Ganti M.B.B.S. [2]

## Overview

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There are no effective or concrete stratagies in preventing suicides. However, American society of Sucidology brought up certain recommendations in identification of risk factors and warning signs to get aware of an individual at risk. American Society of Sucidology also came up with a pneumonic for warning signs 'IS PATH WARM".

## Prevention

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Understanding the issues concerning suicide and mental health is the main stay in prevention of suicide occurrence. American Association of Suicidology recommends tow strategies for effective prevention.[1]

* Identification of Risk Factors
* Warning Signs

### Identification of Risk factors

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Identification of the risk factors cannot predict suicide but can help in getting aware of the individual:[2][3]

* Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders, and certain personality disorders
* Alcohol and other substance use disorders
* Hopelessness
* Impulsive and/or aggressive tendencies
* History of trauma or abuse
* Major physical illnesses
* Previous suicide attempt(s)
* Family history of suicide
* Job or financial loss
* Loss of relationship(s)
* Easy access to lethal means
* Local clusters of suicide
* Lack of social support and sense of isolation
* Stigma associated with asking for help
* Lack of healthcare, especially mental health and substance abuse treatment
* Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
* Exposure to others who have died by suicide (in real life or via the media and Internet)

### Warning Signs

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Warning signs help to determine one at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event. Warning signs include:

* Talking about wanting to die or to kill themselves
* Looking for a way to kill themselves, like searching online or buying a gun
* Talking about feeling hopeless or having no reason to live
* Talking about feeling trapped or in unbearable pain
* Talking about being a burden to others
* Increasing the use of alcohol or drugs
* Acting anxious or agitated; behaving recklessly
* Sleeping too little or too much
* Withdrawing or isolating themselves
* Showing rage or talking about seeking revenge
* Extreme mood swings

Pneumonic for Identification of risk factors

"IS PATH WARM"

I | Ideation
S | Substance abuse – Increased substance use
P | Purposelessness
A | Anxiety – Worry, fear, agitation, or changes in sleep pattern
T | Trapped – Feeling like there is no way out of a bad situation
H | Hopelessness
W | Withdrawal from friends, family, and society
A | Anger
R | Recklessness
M | Mood changes

## References

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1. ↑ Shain B (July 2016). "Suicide and Suicide Attempts in Adolescents". Pediatrics. 138 (1). doi:10.1542/peds.2016-1420. PMID 27354459.
2. ↑ Mulder R, Newton-Howes G, Coid JW (October 2016). "The futility of risk prediction in psychiatry". Br J Psychiatry. 209 (4): 271–272. doi:10.1192/bjp.bp.116.184960. PMID 27698212.
3. ↑ Rudd MD, Berman AL, Joiner TE, Nock MK, Silverman MM, Mandrusiak M, Van Orden K, Witte T (June 2006). "Warning signs for suicide: theory, research, and clinical applications". Suicide Life Threat Behav. 36 (3): 255–62. doi:10.1521/suli.2006.36.3.255. PMID 16805653.

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