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suicidal ideation (SI)

SI is an acronym for suicidal ideation (see suicide) Etiology: - risk factors - veterans who have killed in combat are at increased risk [5] - having a parent die during childhood [6] - cerebral concussion ~ 3-fold risk [7] - self neglect, RR~3-fold (Chinese Americans) [8] - elder mistreatment, including elder neglect - self-reported discrimination ~ 2-fold risk [8] Management: - if someone has a plan to harm themselves or others, or otherwise in iminent danger (active suicidal ideation), hospitalize or emergency department evaluation [2] - passive suicidal ideation requires evaluation of depression & other psychiatric disorders - follow-up in 1 week is recommended - lack of evidence for population-based screening for suicide risk [3]

Interactions

disease interactions

Related

suicide

General

mental disorder

References

  1. Richards JE, Whiteside U, Ludman EJ et al. Understanding why patients may not report suicidal ideation at a health care visit prior to a suicide attempt: A qualitative study. Psychiatr Serv 2018 Nov 20; PMID: 30453860 https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800342
  2. NEJM Knowledge+ Psychiatry
  3. US Preventive Services Task Force Screening for Depression and Suicide Risk in Adults; US Preventive Services Task Force Recommendation Statement. JAMA. 2023;329(23):2057-2067 PMID: 37338872 https://jamanetwork.com/journals/jama/fullarticle/2806144 - Simon GE et al. Reframing the key questions regarding screening for suicide risk. JAMA 2023 Jun 20; 329:2026. PMID: 37338888 https://jamanetwork.com/journals/jama/fullarticle/2806177
  4. Turecki G, Brent DA. Suicide and suicidal behaviour. Lancet. 2016 Mar 19;387(10024):1227-39. PMID: 26385066 PMCID: PMC5319859 Free PMC article. Review.
  5. Maguen S et al. Killing in combat may be independently associated with suicidal ideation. Depress Anxiety 2012 Apr 13 PMID: 22505038 http://onlinelibrary.wiley.com/doi/10.1002/da.21954/abstract
  6. Guldin MB et al Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood. A Population-Based Cohort Study. JAMA Psychiatry. Published online November 11, 2015 PMID: 26558351 http://archpsyc.jamanetwork.com/article.aspx?articleid=2469106
  7. Fralick M, Thiruchelvam D, Tien HC, Redelmeier DA. Risk of suicide after a concussion CMAJ February 8, 2016 PMID: 26858348 http://www.cmaj.ca/content/early/2016/02/08/cmaj.150790
  8. Dong XQ, Xu Y, Ding D. Elder self-neglect and suicidal ideation in a U.S. Chinese aging population: findings from the PINE study. J Gerontol A Biol Sci Med Sci. 2017;72(suppl 1):S76-S81 PMID: 28575261 PMCID: PMC5861963 Free PMC article https://academic.oup.com/biomedgerontology/article/72/suppl_1/S76/3859671 - Dong XQ. Associations between the differential definitions of elder mistreatment and suicidal ideation outcomes in U.S. Chinese older adults: do the definitions matter? J Gerontol A Biol Sci Med Sci. 2017;72(suppl 1):S82-S89 PMID: 28575267 PMCID: PMC5861847 Free PMC article https://academic.oup.com/biomedgerontology/article/72/suppl_1/S82/3859677 - Li LW, Gee GC, Dong XQ. Association of self-reported discrimination and suicide ideation in older Chinese Americans. Am J Geriatr Psychiatry. 2018;26(1):42-51 PMID: 28917505 PMCID: PMC5725252 Free PMC article https://www.ajgponline.org/article/S1064-7481(17)30421-9/fulltext - Wei JW, Zhang J, Deng Y, et al. Suicidal ideation among the Chinese elderly and its correlates: a comparison between the rural and urban populations. PMID: 29495615 PMCID: PMC5876967 Free PMC article https://www.mdpi.com/1660-4601/15/3/422