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Suicide Risk Assessment
Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives. The assessment process is ethically complex: the concept of "imminent suicide" (implying the foreseeability of an inherently unpredictable act) is a legal construct in a clinical guise, which can be used to justify the rationing of emergency psychiatric resources or intrusion into pa ...
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Suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and substance abuse (including alcoholism and the use of and withdrawal from benzodiazepines) are risk factors. Some suicides are impulsive acts due to stress (such as from financial or academic difficulties), relationship problems (such as breakups or divorces), or harassment and bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide such as firearms, drugs, and poisons; treating mental disorders and substance abuse; careful media reporting about suicide; and improving economic conditions. Although crisis hotlines are common resources, their effectiveness has not been well studied. The most commonly adopted metho ...
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African Americans
African Americans (also referred to as Black Americans and Afro-Americans) are an ethnic group consisting of Americans with partial or total ancestry from sub-Saharan Africa. The term "African American" generally denotes descendants of enslaved Africans who are from the United States. While some Black immigrants or their children may also come to identify as African-American, the majority of first generation immigrants do not, preferring to identify with their nation of origin. African Americans constitute the second largest racial group in the U.S. after White Americans, as well as the third largest ethnic group after Hispanic and Latino Americans. Most African Americans are descendants of enslaved people within the boundaries of the present United States. On average, African Americans are of West/ Central African with some European descent; some also have Native American and other ancestry. According to U.S. Census Bureau data, African immigrants generally do not se ...
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Narcissistic Personality Disorder
Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration, a diminished ability or unwillingness to empathize with others' feelings, and interpersonally exploitative behavior. Narcissistic personality disorder is one of the sub-types of the broader category known as personality disorders. It is often comorbid with other mental disorders and associated with significant functional impairment and psychosocial disability. Personality disorders are a class of mental disorders characterized by enduring and inflexible maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by any culture. These patterns develop by early adulthood, and are associated with significant distress or impairment. Criteria for diagnosing personality disorders are listed in the fifth chapter of the ''International ...
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Antisocial Personality Disorder
Antisocial personality disorder (ASPD or infrequently APD) is a personality disorder characterized by a long-term pattern of disregard of, or violation of, the rights of others as well as a difficulty sustaining long-term relationships. Lack of empathy is often apparent, as well as a history of rule-breaking that can sometimes include law-breaking, a tendency towards substance abuse, and impulsive and aggressive behavior. Antisocial behaviors often have their onset before the age of 8, and in nearly 80% of ASPD cases, the subject will develop their first symptoms by age 11. The prevalence of ASPD peaks in people age 24 to 44 years old, and often decreases in people age 45 to 64 years. In the United States, the rate of antisocial personality disorder in the general population is estimated between 0.5 and 3.5 percent. In a study, a random sampling of 320 newly incarcerated offenders found ASPD was present in over 35 percent of those surveyed. Personality disorders are a class o ...
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Borderline Personality Disorder
Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong emotional reactions. Those affected often engage in self-harm and other dangerous behaviors, often due to their difficulty with returning their emotional level to a healthy or normal baseline. They may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality. Symptoms of BPD may be triggered by events considered normal to others. BPD typically begins by early adulthood and occurs across a variety of situations. Substance use disorders, depression, and eating disorders are commonly associated with BPD. Some 8 to 10% of people affected by the disorder may die by suicide. The disorder is often stigmatized in both the media and the psychiatric field and as a result is often underdiagnosed. The causes of ...
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Personality Disorder
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the ''International Classification of Diseases'' (ICD) and in the American Psychiatric Association's '' Diagnostic and Statistical Manual of Mental Disorders'' (DSM). Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish individual humans. Hence, personality disorders are defined by experiences and behaviors that deviate from social norms and expectations. Those diagnosed with a personality disorder may experience difficulties ...
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Mood Disorders
A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where a disturbance in the person's mood is the main underlying feature. The classification is in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) and International Classification of Diseases (ICD). Mood disorders fall into seven groups, including; abnormally elevated mood, such as mania or hypomania; depressed mood, of which the best-known and most researched is major depressive disorder (MDD) (alternatively known as clinical depression, unipolar depression, or major depression); and moods which cycle between mania and depression, known as bipolar disorder (BD) (formerly known as manic depression). There are several sub-types of depressive disorders or psychiatric syndromes featuring less severe symptoms such as dysthymic disorder (similar to MDD, but longer lasting and more persistent, though often milder) and cyclothymic disorder (simila ...
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Schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdrawal, decreased emotional expression, and apathy. Symptoms typically develop gradually, begin during young adulthood, and in many cases never become resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a history that includes the person's reported experiences, and reports of others familiar with the person. To be diagnosed with schizophrenia, symptoms and functional impairment need to be present for six months (DSM-5) or one month (ICD-11). Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder. About 0.3% to 0.7% of people are diagnosed with schizophrenia during their lifetime. In 2 ...
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Anorexia Nervosa
Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Greek origin: ''an-'' (ἀν-, prefix denoting negation) and ''orexis'' (ὄρεξις, "appetite"), translating literally to "a loss of appetite"; the adjective ''nervosa'' indicating the functional and non-organic nature of the disorder. ''Anorexia nervosa'' was coined by Gull in 1873 but, despite literal translation, the feeling of hunger is frequently present and the pathological control of this instinct is a source of satisfaction for the patients. Individuals with anorexia nervosa have a fear of being overweight or being seen as such, although they are in fact underweight. The DSM-5 describes this perceptual symptom as "disturbance in the way in which one's body weight or shape is experienced". In research and clinical settings, thi ...
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Suicide Note
A suicide note or death note is a message left behind by a person who dies or intends to die by suicide. A study examining Japanese suicide notes estimated that 25–30% of suicides are accompanied by a note. However, incidence rates may depend on ethnicity and cultural differences, and may reach rates as high as 50% in certain demographics. A suicide message can be in any form or medium, but the most common methods are by a written note, an audio message, or a video. Reasons Some fields of study, such as sociology, psychiatry and graphology, have investigated the reasons why people who complete or attempt suicide leave a note. The most common reasons that people contemplating suicide choose to write a suicide note include one or more of the following: *To ease the pain of those known to the victim by attempting to dissipate guilt. *To increase the pain of survivors by attempting to create guilt. *To set out the reason(s) for suicide. *To send a message to the world. *To exp ...
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Research Domain Criteria
The Research Domain Criteria (RDoC) project is an initiative of personalized medicine in psychiatry developed by US National Institute of Mental Health (NIMH). In contrast to the Diagnostic and Statistical Manual of Mental Disorders (DSM) maintained by the American Psychiatric Association (APA), RDoC aims to address the heterogeneity in the current nosology by providing a biologically-based, rather than symptom-based, framework for understanding mental disorders. "RDoC is an attempt to create a new kind of taxonomy for mental disorders by bringing the power of modern research approaches in genetics, neuroscience, and behavioral science to the problem of mental illness." Call for creation The 2008 NIMH Strategic Plan calls for NIMH to "Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures." The strategic plan continues: Currently, the diagnosis of mental disorders is based on clinical obse ...
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