Response to a Single Question May Flag Suicide Risk

[Retired]

Response to a Single Question May Flag Suicide Risk
Medscape Medical News
December 6, 2013

A specific response to a single question from a commonly used depression scale may help clinicians flag patients at increased risk for suicide, new research suggests.

A study of more than 84,000 patients with depressive symptoms who completed the Patient Health Questionnaire (PHQ-9) at every outpatient visit for depression care during a 4-year period showed that respondents who reported that they thought about death or self-harm "nearly every day" had more than a 6-fold increased risk for suicide attempt compared with respondents who did not consider these options.

According to investigators, led by Gregory E. Simon, MD, MPH, from the Group Health Research Institute in Seattle, Washington, patients who reported thoughts of death or self-harm "more than half the days" or "nearly every day" accounted for 53% of suicide attempts and 54% of suicide deaths. [SUB](bolding by Psychlinks)[/SUB]

Interestingly, the immediate risk for suicidal behavior after completing the PHQ-9 was low, but the risk increased during several days and continued to grow for several months after.

"Suicidal ideation should be viewed as an enduring vulnerability rather than simply a short-term crisis," write the investigators. "These findings emphasize the need for sustained and organized follow-up care to address ongoing risk."

The study was published in the December issue of Psychiatric Services

 

[W00BY]

It is such a taboo subject but in my studies I have been taught to ask this question quite bluntly...obviously not so as to make the person more reluctant to speak or encourage such behaviour but so as to open up a dialogue about this thought and identify it as a possible issue.

I was (in my training) very nervous of asking such a thing it is a very taboo subject and to all involved with these thought patterns a very emotive subject however I have been amazed at how honest most people will be about these thoughts.

If no one asks no one may never know until it is too late...and it is surprising how many people have these thoughts on a regular basis and if just asked will discuss them.

 

[Retired]

I have been taught to ask this question quite bluntly...obviously not so as to make the person more reluctant to speak or encourage such behaviour but so as to open up a dialogue about this thought and identify it as a possible issue.

There is a perception among many people that confronting the subject of suicide with a person who appears to show signs of being suicidal, encourages them to pursue their suicidal path.

In fact, according to the training provided by Living Works in the Asist Suicide Intervention program people contemplating suicide send out signals to friends, family and therapists about their thoughts, with the hope they can talk about their distress.

Because of the taboos surrounding suicide and most peoples lack of knowledge of how to address the subject of suicide, sadly, many people with suicidal ideation are ignored.

Talking about suicide with someone contemplating suicide does not drive the person to suicide. Instead it give them the opportunity to express their distress and allows the opportunity to be directed to receive professional help.

 

[Cat Dancer]

Maybe when someone thinks about suicide or self harm a lot then it doesn't seem like such a big deal. It seems "normal." And sometimes maybe the thoughts are so strong someone just wants to go through with it to get the thoughts to stop, to get some peace.

 

[Retired]

And sometimes maybe the thoughts are so strong someone just wants to go through with it to get the thoughts to stop, to get some peace.

...and just maybe the sensible approach might be to recognize that completing a suicide because of intrusive thoughts is distorted thinking.

Intrusive thoughts might just be a symptom of OCD thinking, which is a treatable disorder. With the right kind of therapy, strategies can be learned to manage the symptoms of OCD and to recognize that intrusive thoughts are thoughts and not reality.

 

[Banned]

You took the words out of my mouth, Steve. I think about suicide a lot and talk about it a lot but my therapist has taught me that this is OCD thinking and nothing more. Sure, the thoughts are tormenting at times and I can't seem to make them go away but that's where other strategies learned in therapy come in.

If I ever believe myself to be truly suicidal, and I have in the past, I would want someone, most of all my therapist, to talk to me. Skirting the issue just makes me feel more alone and that my feelings are unimportant or don't matter.

 

[Cat Dancer]

I believe the suicidal thoughts I have are way more related to depression and anorexia than anything else.

 

[rdw]

I think about suicide when times are tough - it's like my fall back plan when I can't stand the emotional pain for another minute. Like Turtle I've learned to realize that it is distorted thinking.

 

[Cat Dancer]

My old therapist told me to pray them away, rebuke satan and all that. He also thought you could pray away being gay.

 

[rdw]

He's a religious zealot not a therapist.

 

[Cat Dancer]

Well, I know one thing, I never want to see a Christian therapist again. Ever.

 

[Banned]

My old therapist told me to pray them away, rebuke satan and all that. He also thought you could pray away being gay.

If it was that easy there'd be a lot of therapists out of business. :facepalm:

 

[W00BY]

It is the only control left in times of EXTREME stress...whether you live or die and like RDW heavy levels of stress in my life would make me feel like it was a good idea in fact you mirrored my thought exactly with "back up plan"...it is like a plan to sort out, runaway, relieve, distance etc yourself from you own mind and problems and yes the distorted thinking is..."this is a good idea"

No one around me knew about my plan I had for many years and I have even scuffed over it lightly in my therapy because it is a recognition for me not only how little I value myself but also how low things have and will get me...I have to admit I am finding it difficult to talk about now!

It shows how private an ideation it is!