Tuesday, March 8, 2011

Manned OSCE - Suicide Risk Assessment

Score >7 = high suicide risk

updated from here


1. Have you attempted suicide?
# A : No --> low risk
# B : Yes --> higher risk

2. Have you thought about dead?

3. Have you thought about suicidal (suicidal ideation)?
# No : lower risk
# Yes : higher risk

4. If yes to questions (3) :
# what kind of thought?
# method? (> serious/dangerous method, > higher risk)
# how often you thought of it?
# any specific plan?
# have you told others about the plan?
# have you actually ever attempted? (to reconfirm back with patient)
# what stop you from attempt suicide? (protective factors)
# have you make any suicidal note?
# have you make the will?
# conditions
***if patient method is to drink paraquat, have he bought the paraquat?
***if patient want to jump from high places, ask him whether he live in terrace, condo, apartment

5. ask this to patient who had attempt suicide previously (additional)
# what is the method? evaluate how dangerous is the method
# what is the chance of dying? (lock door, nobody at home, alone, etc...)
# what is the chance of rescue? (anybody at home? has tell others? etc..)
# intention of attempt? (very high? not really want to attempt?)
# what is his/her feeling after being rescued? (relief? angry to the rescuer? etc..)

6. ask to all (other factors)
# psychotic illness?
# severe depression
# alcoholism / substance abuse
# physical illness
# severe stressor
# no support
# live alone
# others.......

In the exam, evaluate this patient suicide risk subjectively based on the answers you get from the patients.
No need to use scale or score in the manned osce.
Use logical thinking. ^_^

Teaching from Prof Maniam.


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