Psychiatry 精神病学 Wang Keqin Jining Medical College
6.Suicide and deliberate self-harm gaspirtz.com Get down from there!The neighbors are looking!
6.1 Epidemiology Suicide statistics.United States:2004 Suicide rates Males 17.7per100,000 Females 4.6per100,000 Total 11.1per100,000 Gender ratios Suicide completions 3.7 male suicides for each female suicide Suicide attempts 3 female attempts for each male attempt Jinig Mvedical College
6.2 Factors affecting risk Depression Gender-male Ethnicity-white Anxiety Age-elderly Panic attacks Substance abuse Psychosis Past attempts Sleep disorders Means,especially access to guns Family history Substance abuse Hopelessness Command hallucinations Unemployed Comorbid medical conditions Failed relationship,divorced,widowed Jinig Medical College
6.3 Risk assessment Suicide risk factors assessed and weighed (low,moderate,high) Protective factors assessed and weighed (low,moderate,high) Overall assessment rating (low,moderate,high,or range) Treatment and management intervention informed by the assessment Effectiveness of interventions evaluated Jinig Medical College
Goals to Reduce Suicide 1.Promote awareness that suicide is a public health problem that is preventable 2.Develop broad-based support for suicide prevention 3.Develop and implement strategies to reduce the stigma associated with being a consumer of mental health,substance abuse,and suicide prevention services 4.Develop and implement suicide prevention programs 5.Promote efforts to reduce access to lethal means and methods of self-harm 6.Implement training for recognition of at-risk behavior and delivery of effective treatment 7.Develop and promote effective clinical and professional practices 8.Improve access to,and community linkages with,mental health and substance abuse services 9.Improve reporting and portrayals of suicidal behavior,mental illness,and substance abuse in the entertainment and news media 10.Promote and support research on suicide and suicide prevention 11.Improve and expand surveillance systems Copyright07Woters Kler H Lippincott WmWlin
7.Eating disorders Jinig Medical College
7.1 An Overview Two Major Types of DSM-IV Eating Disorders Anorexia nervosa and bulimia nervosa Severe disruptions in eating behavior Extreme fear and apprehension about gaining weight Have strong sociocultural origins-Westernized views Other Subtypes of DSM-IV Eating Disorders Binge-eating disorder Obesity Jinig Medical College
7.2 Anorexia nervosa ANOREXIA NERVOSA Characteristics Intense fear of obesity and persistent pursuit of thinness; perpetual dissatisfaction with weight loss Severe caloric restriction,often with excessive exercise and sometimes with purging,to the point of semi-starvation Severely limiting caloric intake may cause cessation of menstruation,downy hair on limbs and cheeks,dry skin,brittle hair or nails,sensitivity to cold,and danger of acute cardiac or kidney failure Weight at least 15%below normal Average age of onset is about 13 years of age
B.Anorexia Nervosa Genetic Psychological predisposition changes Deliberate Psychological vomiting factors Abnormal regulation of Laxative abuse Sociocultural factors 个 Cortisol↑ Extreme physical Gonadotropin activity Hypothermia Bradycardia Loss of hair etc. Weight loss (on average-45%) Malnutrition Cachexia Jinig Medical College