Suicide

Notes
  • Suicide is the act of purposely ending one's own life
  • Statistics: Globally > 800,000 people commit suicide annually (and it is thought that 20 times this number, or 16 million, have attempted suicide); the proportion of people with suicide ideation (thoughts and plans) is still unknown, globally, it is the second cause of deaths among the 15-29yrs old; in Kenya, suicide is among the top 20 cause of death (cause no.20) while in USA, it is the 10th cause of death in general population; 75% of global suicides (2012) occur in low- and middle-income countries; the most common methods of suicide globally is ingestion of pesticide (about 30%), hanging and firearms; in USA, men are 4 times more likely to commit suicide than female but women attempt suicide 2 to 3 times more often than men; in USA, about 1 in 6 people who commit suicide leave the suicide note
  • Risk factor for suicide include: depression and other mental disorders such as schizophrenia, previous attempt(s) to commit suicide, breakdown in the ability to deal with life stresses (e.g. financial problems, relationship break-up, chronic pain and illness), abuse, violence, serious physical disorders, abuse of alcohol and other substances of abuse, family history of suicide and discrimination
  • People who stay alone are likely to commit suicide

##Stigma and taboo associated with suicide;

  • Many candidates of committing suicide do not seek help
  • Policy makers lack awareness of suicide as a major public health problem
  • The taboo in many societies to openly discuss suicide.
Symptoms

Symptoms and signs of suicide tendency:

  • The condition is usually asymptomatic
  • A feeling of isolation and withdrawal with few friends or family members
  • A preoccupation with death
  • Distraction and lack of humor
  • Dwelling on past losses and defeats and anticipate no future
  • Feeling that others and the world would be better off without them
  • Self-loathing, self-hatred
  • Hopelessness and helplessness
  • Saying good-bye to loved ones, putting affairs in order
  • Dramatic mood swings
Diagnosis
  • Clinical review
Differential
  • Not applicable
Prevention
  • Follow-up care and provision of support for people who have attempted suicide in the past.
  • Effective identification, treatment and care of people with psychological disorders, acute emotional distress, chronic pain and problems with drug abuse
  • Measures to reduce availability if items that are used to commit suicide (e.g. pesticides and firearms)
  • Streamlining of alcohol policies to reduce the harmful use of alcohol
  • Coordination and collaboration among multiple sectors of society and government to prevent suicide
  • Avoiding leaving the person alone
Management
  • Regard every suicide attempt seriously as the next attempt could be successful
  • A person who is threatening to commit suicide should be transferred to a psychiatric facility
  • Emergency management of poisoning in an attempted suicide
  • Building of rapport patient and understanding the background of situation
  • Interviewing the family members
  • Provide ant-depressants when indicated
  • Discuss with family members and friends about the cause(s) and solution of attempted suicide
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