n544 screening for suicide risk

8/7/2019 N544 Screening for Suicide Risk

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SCREENING FOR SUICIDE RISKRhonda Centuolo

Deborah Kaiser

Nurs 544


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FACING THE FACTS

Suicide is the second leading cause of deathfor people aged 24-34.

Suicide is the third leading cause of death forpeople aged 10-24.

Suicide is the fourth leading cause of death foradults between the ages of 18 and 65.

Suicide is highest in white males over 85.

(45.4/100,000, 2007)

www.cdc.gov & www.nimh.nih.gov


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SOCIO-DEMOGRAPHIC RISK FACTORS

MaleOver age 65WhiteSeparated,

widowed or

divorcedLiving aloneBeing unemployed

or retiredOccupation:

health-related

occupationshigher (dentists,doctors, nurses,social workers)

www.afsp.org


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PREVENTION MAY BE A MATTER OF A

CARING PERSON WITH THE RIGHT

KNOWLEDGE BEING AVAILABLE IN

THE RIGHT PLACE AT THE RIGHT

TIME.


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ASSESSING FOR RISKS

Past Attempts

After a suicide

attempt that is

seenin the ER about

1% per year take

their own life, up

to approximately

10% within 10

years

www.afsp.org


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HOW DO WE SCREEN?

Providers need to be aware of risk factors

Talk to patients

y Asking patients about sleep disturbance, depressedmood, guilt, and hopelessness correctly identified

84% of those who had experienced suicidal thoughts

within the previous year

Refer and Follow up as needed


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PROPOSED DSM-V SUICIDE ASSESSMENT

DIMENSION

Level of concern aboutLevel of concern about

potential suicidal behavior:potential suicidal behavior:

(sum of items coded as(sum of items coded as

present)present)

1. 0: Lowest concern1. 0: Lowest concern

2. 12. 1--2: Some concern2: Some concern

3. 33. 3--4: Increased concern4: Increased concern

4. 54. 5--7: High concern7: High concern

11. Any history of a suicide attempt. Any history of a suicide attempt

2. Long2. Long--standing tendency to losestanding tendency to lose

temper ortemper or

become aggressive with littlebecome aggressive with little

provocationprovocation

3. Living alone, chronic severe pain, or3. Living alone, chronic severe pain, or

recentrecent

(within 3 months) significant loss(within 3 months) significant loss

4. Recent psychiatric4. Recent psychiatric

admission/discharge oradmission/discharge or

first diagnosis ofMDD, bipolarfirst diagnosis ofMDD, bipolar

disorder ordisorder or

schizophreniaschizophrenia

5. Recent increase in alcohol abuse or5. Recent increase in alcohol abuse or

worsening of depressive symptomsworsening of depressive symptoms

6. Current (within last week)6. Current (within last week)

preoccupationpreoccupation

with, or plans for, suicidewith, or plans for, suicide

7. Current psychomotor agitation,7. Current psychomotor agitation,

markedmarked

anxiety or prominent feelings ofanxiety or prominent feelings of

hopelessnesshopelessnesswww.afsp.org


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SCREENING RECOMMENDATIONS

USPSTF:

There is insufficient evidence to recommend for oragainst routine screening by primary careclinicians to detect suicide risk in asymptomatic

persons (I" recommendation).

The Canadian Task Force on the Periodic Health:

Examination found insufficient evidence to

recommend for or against the inclusion of suiciderisk evaluation in the periodic healthexamination


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SCREENING RECOMMENDATIONS

The American Academy of Pediatrics

recommends asking all adolescents about suicidal

thoughts during the routine medical history.

The Joint Commission: NPSG 15 Identify

patients at risk for suicide (2010 standards)


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n544 screening for suicide risk

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