An attempted conscious act of self-destruction which the individual concerned views as the best solution

- usually associated with feelings of hopelessness and helplessness and conflicts between survival and stress

Causes

Physical illness, eg.

• HIV/AIDS
• Head injury
• Malignancies
• Bodily disfigurement

Psychiatric disorders, eg.

• Depression, schizophrenia, dementia
• Chronic alcohol abuse
• Personality disorders
• Epilepsy

Risk of suicide

Risk is high if:

• Patient >45 years old
• Associated alcoholism
• History of suicide attempts
• Evidence of violent behaviour or previous psychiatric admission

Risk may be low if patient is:

• <45 years old
• Married
• Employed
• In stable interpersonal relationships
• In good physical health

Note

Suicide is relatively rare in children and adolescents. However there is increased risk if there is:

♦ Disturbed family background, eg. death of parents, divorce
♦ Use of alcohol other drugs of abuse
♦ Physical illness
♦ Psychiatric disorder

Management

Identify cause for suicidal behaviour and treat as an emergency, eg. depression
Carefully observe patient to minimize risk of self-harm
Provide adequate psychological care

Prevention

• Identify and manage risk factors
• Ensure good psychosocial support