The assessment of suicidal thoughts or behavior and its managementare topics relevant to all clinicians, not just mental healthprofessionals. Up to two thirds of patients who commit suicidehave seen a physician in the month before their death.1,2,3,4,5Many patients who kill themselves do so by taking an overdoseof prescribed medications, and physicians sometimes unwittinglyprovide the means for suicide in a single prescription.3 Fewpatients spontaneously report their suicidal thoughts and intentionsto their physicians,4 so the clinician must be alert to signalsthat a patient may be at risk for suicide. Although the patientmay . . . [Full Text of this Article]
Case Examples
Case 1
Case 2
Case 3
Case 4
Epidemiology
Identification and Assessment
Management
Management after a Suicide
A Note about Physician-Assisted Suicide
Conclusions
Source Information
From the Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston, Room 1.200, Graves Bldg., Galveston, TX 77555-0429, where reprint requests should be addressed to Dr. Hirschfeld.
References
Related Letters:
Treatment of Suicidal Patients
Bostwick J. M., Pochard F., Robin M., Kannas S., Simcic K. J., Müller-Oerlinghausen B., Hirschfeld R. M.A., Russell J. M.
Extract |
Full Text
N Engl J Med 1998;
338:261-262, Jan 22, 1998.
Correspondence
This article has been cited by other articles:
Lam, B. L., Christ, S. L., Lee, D. J., Zheng, D. D., Arheart, K. L.
(2008). Reported Visual Impairment and Risk of Suicide: The 1986-1996 National Health Interview Surveys. Arch Ophthalmol
126: 975-980
[Abstract][Full Text]
Laje, G., Paddock, S., Manji, H., Rush, A. J., Wilson, A. F., Charney, D., McMahon, F. J.
(2008). Genetic Markers of Suicidal Ideation Emerging During Citalopram Treatment of Major Depression. Focus
6: 69-79
[Abstract][Full Text]
Laje, G., Paddock, S., Manji, H., Rush, A. J., Wilson, A. F., Charney, D., McMahon, F. J.
(2007). Genetic Markers of Suicidal Ideation Emerging During Citalopram Treatment of Major Depression. Am. J. Psychiatry
164: 1530-1538
[Abstract][Full Text]
Tepper, M., Whitehead, J.
(2005). Cognitive Therapy and Preventing Suicide Attempts. JAMA
294: 2847-2847
[Full Text]
Sher, L.
(2004). Preventing suicide. QJM
97: 677-680
[Full Text]
Baca-Garcia, E., Diaz-Sastre, C., Resa, E. G., Blasco, H., Conesa, D. B., Saiz-Ruiz, J., de Leon, J.
(2004). Variables Associated With Hospitalization Decisions by Emergency Psychiatrists After a Patient's Suicide Attempt. Psychiatr. Serv.
55: 792-797
[Abstract][Full Text]
Gaynes, B. N., West, S. L., Ford, C. A., Frame, P., Klein, J., Lohr, K. N.
(2004). Screening for Suicide Risk in Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force. ANN INTERN MED
140: 822-835
[Abstract][Full Text]
Rollman, B. L., Shear, M. K.
(2003). Depression and Medical Comorbidity: Red Flags for Current Suicidal Ideation in Primary Care. Psychosom. Med.
65: 506-507
[Full Text]
Luoma, J. B., Martin, C. E., Pearson, J. L.
(2002). Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence. Am. J. Psychiatry
159: 909-916
[Abstract][Full Text]
Williams, J. W. Jr, Noel, P. H., Cordes, J. A., Ramirez, G., Pignone, M.
(2002). Is This Patient Clinically Depressed?. JAMA
287: 1160-1170
[Abstract][Full Text]
Mann, J. J.
(2002). A Current Perspective of Suicide and Attempted Suicide. ANN INTERN MED
136: 302-311
[Abstract][Full Text]
Gross, R., Olfson, M., Gameroff, M., Shea, S., Feder, A., Fuentes, M., Lantigua, R., Weissman, M. M.
(2002). Borderline Personality Disorder in Primary Care. Arch Intern Med
162: 53-60
[Abstract][Full Text]
Kroll, J.
(2000). Use of No-Suicide Contracts by Psychiatrists in Minnesota. Am. J. Psychiatry
157: 1684-1686
[Abstract][Full Text]
Schwenk, T. L., Jacobs, D. G.
(2000). Screening for Depression in Primary Care. JAMA
284: 1379-1380
[Full Text]
Akechi, T., Okamura, H., Kugaya, A., Nakano, T., Nakanishi, T., Akizuki, N., Yamawaki, S., Uchitomi, Y.
(2000). Suicidal Ideation in Cancer Patients with Major Depression. Jpn J Clin Oncol
30: 221-224
[Abstract][Full Text]
Hirschfeld, R. M. A.
(2000). Suicide and Antidepressant Treatment. Arch Gen Psychiatry
57: 325-326
[Full Text]
Wintemute, G. J., Parham, C. A., Beaumont, J. J., Wright, M., Drake, C.
(1999). Mortality among Recent Purchasers of Handguns. NEJM
341: 1583-1589
[Abstract][Full Text]
Hall, R. C. W., Platt, D. E., Hall, R. C. W.
(1999). Suicide Risk Assessment: A Review of Risk Factors for Suicide in 100 Patients Who Made Severe Suicide Attempts: Evaluation of Suicide Risk in a Time of Managed Care. Psychosomatics
40: 18-27
[Abstract][Full Text]
Shepherd, G., Klein-Schwartz, W.
(1998). Accidental and Suicidal Adolescent Poisoning Deaths in the United States, 1979-1994. Arch Pediatr Adolesc Med
152: 1181-1185
[Abstract][Full Text]
Cohen, L. M.
(1998). Suicide, Hastening Death, and Psychiatry. Arch Intern Med
158: 1973-1976
[Full Text]
Friedmann, P. D., Saitz, R., Samet, J. H.
(1998). Management of Adults Recovering From Alcohol or Other Drug Problems: Relapse Prevention in Primary Care. JAMA
279: 1227-1231
[Abstract][Full Text]
Bostwick, J. M., Pochard, F., Robin, M., Kannas, S., Simcic, K. J., Muller-Oerlinghausen, B., Hirschfeld, R. M.A., Russell, J. M.
(1998). Treatment of Suicidal Patients. NEJM
338: 261-262
[Full Text]