gc08-6 - Suicide Assessment in the Elderly Geriatric...

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Unformatted text preview: Suicide Assessment in the Elderly Geriatric Psychiatric for the Primary Care Provider 2008 Lisa M. Brown, Ph.D. Aging and Mental Health Louis de la Parte Florida Mental Health Institute University of South Florida A Typical Scenario Suicide Facts Mental Health Clinicians have more than a 1 in 5 chance of having a patient commit suicide Average of 1 American every 16 minutes 2004 Official Data USA 32,000 people (89 per day) commit suicide 11th leading cause of death in the USA Males, age 75 and older have the highest rates of suicide (rate 37.4 per 100,000) Suicide Facts Suicide is an intended death. It is done by oneself to oneself and can be indirect or passive Suicide attempters and completers are distinct but overlapping populations Suicide Facts Women attempt suicide more often than men Men complete suicide more often than women at the rate of 4 to 1 Attempted Suicide United States, 2004 Source: CDC, NCHS - death certificates, Natl. Hospital Discharge Survey, Natl.. Hospital Ambulatory Care Medical Care Survey Crosby et al, 1999 Deaths Hospitalizations Emergency Dept visits 32,000+ 154,598 372,722 1 5 30 1,768,000 No treatment Sought 60 Number Proportion Suicide Facts Firearms are the most common method of suicide in the US, followed by hanging Suicide by firearms accounted for 57% of all suicides 71% of suicide committed by older adults involve a firearm The risk of suicide increases by nearly 5 times in homes with guns (Kellermann, 1992) High Rate of Male Suicide is a Problem Suicide Facts Suicide risk is highest for depression, placing an individual at twenty-one times the expected risk, followed by bipolar disorder substance abuse schizophrenia personality disorders anxiety disorders Older Adults The elderly make up 12% of the population (US) but represent 16% of the suicides Among the highest rates (when categorized by gender and race) are suicide deaths for white men over 85, who had a rate of 59/100,000 Suicide is a Risk Factor for Which Two DSM-IV Diagnosis? Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior Assessing Suicide Risk Problems in Assessing Suicide Risk No assessment measure is sensitive enough to identify those that will commit suicide and accurate enough to avoid false predictions...
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gc08-6 - Suicide Assessment in the Elderly Geriatric...

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