Suicide

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Mood disorders in older adults are neither inevitable nor particularly resistant to treatment. With attention to the special needs of older patients during evaluation, treatment, and follow up, clinicians can help many patients derive greater enjoyment from their later years.

The ethical status of suicide is not a question psychiatrists can ignore. After all, our duty to preserve and protect life is founded on moral values, even if they are so deeply embedded in our medical ethos that we no longer sense their moral underpinnings.

It is hard for mental health professionals to discuss completed suicides. Legal fears, confidentiality concerns, shame, and stigma are formidable obstacles. But talk we must, for talking-and listening-is a key to prevention and treatment.

Some attorneys have argued that SSRIs cause serious adverse events, capable of compelling defendants to engage in strikingly complex criminal behavior. On close examination, however, these phenomena may be clearly distinguished from criminal behavior.

Preventing Inpatient Suicide

Inpatient suicides are viewed as the most avoidable and preventable because they occur in close proximity to staff. Included here are factors that may guide the clinician in treating these at-risk patients.

Mini-quiz: Suicide

Approximately what percentage of adults have made a serious suicide attempt?

The rise in suicides and lethal overdoses of opioid analgesics is probably not coincidental. In most overdose deaths, we have no way of knowing with any degree of certainty whether they were accidental deaths or intentional suicides.

According to the CDC's latest published report, there were 38,364 suicides in the US in 2010-an average of 105 each day. Globally, an estimated 1 million suicides occur annually.

Patients with major depression or bipolar depression have a 20- to 26-fold increase of mortality rate over the general population. Suicidal behavior can be quite complex as well deadly. It should go without saying that psychotherapy is usually necessary in treating patients who have suicidal ideation or who have demonstrated such tendencies or actions. Frequently, it may be combined with medication and sometimes it is the treatment of choice without medication.