Completed suicide in medical/surgical patients: Who is at risk?

  title={Completed suicide in medical/surgical patients: Who is at risk?},
  author={John Michael Bostwick and Sandra J. Rackley},
  journal={Current Psychiatry Reports},
Factors contributing to patients killing themselves while admitted to general hospital medical/surgical (med/surg) units have not been well described. These rare yet devastating suicides appear to have characteristics distinguishing them from suicides in psychiatric inpatients. This article emphasizes the importance of both agitation and readily available lethal means in suicides that are almost invariably impulsive. It also emphasizes how traditional risk factors such as past history of… 
Recognizing And Managing Hospitalized Patients Who Are At Risk For Suicide
The current evidence-based recommendations available for management of suicidal patients in the hospital setting are reviewed, including a special focus on protective factors and symptoms associated with completed suicide, chronic medical conditions associated with suicide, and special high-risk populations the hospitalist needs to note.
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It is concluded that management strategies for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment and is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.
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Recommendations for managing suicidal patients on medical-surgical and intensive care units are made, including improved education for staff, standardized communication about suicide risk, and clear management protocols for suicidal patients.


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Data from an ongoing prospective investigation evaluating the suicide risk in patients with major affective disorders have identified several heretofore unrecognized factors as highly correlated with early suicide.
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  • Medicine, Psychology
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For patients admitted to general wards because of attempted suicide, the risk is highest just after admission; hence, these patients have to be monitored closely and a high degree of alertness to the possibility of depression and suicidal risk among general ward patients is required.
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Depression and/or substance use disorders were risk factors for suicide and screening for those disorders may be beneficial for suicide prevention in the general hospital population, but will likely benefit more patients who will not commit suicide.
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