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SUICIDE: RISK FACTORS

SUICIDE: RISK FACTORS. Dr. Nooshin Parvaresh Child & Adolescent Psychiatrist Kerman University Of Medical Sciences. suicide. Involves continiuum from non-suicidal behavior to suicidal ideas, suicide attempts and suicide

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SUICIDE: RISK FACTORS

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  1. SUICIDE:RISK FACTORS Dr. NooshinParvaresh Child & Adolescent Psychiatrist Kerman University Of Medical Sciences

  2. suicide • Involves continiuum from non-suicidal behavior to suicidal ideas, suicide attempts and suicide • Consider self-injurious acts as potentially suicidal in youths (reversibility, fluctuating and not for themselves believes, impaired lathality estimation) • more sever self-harm and later suicide with self-harm behavior

  3. PRIMARY PSYCHIATRIC DISORDERS • Psychological autopsy : 90% psychiatry disorder 32-54% major depressive disorder 1/5 bipolar disorders comorbidity substance abuse • Non-fatal suicidal behavior : same psychiatric disorders substance abuse sexual orientation in male Evaluate suicidal risk during all evaluations

  4. Developmental and personality disorders • Borderline, antisocial, narcissistic, schizoid traits • Chronic aggression • Impulsivity • Odd thinking • Mood instability • Poor interpersonal relationship • Neuroticism Identify traits that suggest future personality disorder

  5. Neurobiological risk factors • Serotonin dysregulation • Growth hormone secretion • HPA axis dysregulation • Gene environmental interaction May point toward new treatment options

  6. Environmental stress risk factors • Family loss • Parental psychiatric disorder and substance abuse • Family suicidal behavior by transmission of impulsive aggression • Exposure to violence and assaultive behavior

  7. Environmental stress risk factors • Physical abuse, mediated by stressors and mental health problems • Sexual abuse, risk rises with severity and transmits to subsequent generations • Emotional neglect as predictor of self harm • Exposure to suicide

  8. Environmental stress risk factors • Early physical stress • Chronic medical illness • Functional impairment • School drop out • Economic strain

  9. Social maladjustment risk factors • Impaired interpersonal relations • Low self esteem • Sense of incompetence • Social support (inability to communicate openly) • Predictability of environment (inadequacies in mobilizing support)

  10. Other risk factors for suicide • Previous self harm or suicidal attempt • Quality of childhood attachment • Poor problem solving skill • Ego mechanisms: -denial of affects and events -reaction formation, exaggeration of skills

  11. Other risk factors for suicide • Availability of lethal agents (impulsive acts) • Cultural factors • Same sex orientation ,mediated by family rejection and abuse

  12. Other risk factors for suicide • Bulling by peers -higher frequency -family adversity -presence of maltreatment -family history of suicidal behaviors -symptoms of depression, psyhosis, and conduct -borderline personality traits

  13. Other risk factors for suicide Medications • warning for all classes antidepressant - for depressed youth - increase clinical monitoring • Use medications specific to diagnosis - caution for disinhibition • Restriction the availability of acetaminophen in some countries

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