2. Pyschiatric
emergency
• It is a condition
where the patient
has disturbances of
thought, affect &
Psychomoter activity
leading to a threat
to his/her life
3. Common psychiatric emergencies
Suicidal
attempt &
committing
suicide
Violent,
Aggressive
behaviour
Excitement or
overactive
patient
Overdose of
alcohol
Severe
depression
Abnormal
response to
stressful
situation
Disaster
eg- Natural
& Man made
6. Introduction
In psychiatry a suicidal
attempt is considered to
be one of the commonest
emergencies
Suicide is a type of
deliberate self harm &
is defined by an
intentional human act of
killing oneself
7. Definition
Aggression toward the self following the
internalisation of frustration or
disappointment related to loved ones
A murderous attack on an internalized
object which has become a source of
ambivalence
The loved object has become introsected by
the individual the act of suicide is
directed to the self physically, but
towards loved one is a psychological sense
8. Causes • 1)Phychiatric disorder
+ Major depression
+Schizophrenia
+Drug or alcohol abuse
+Dementia
+Delirium
+Personality disorder
9. • 2) Physical disorder
+Patient with incurable or painfull physical
disorder like Cancer,Aids
10. • 3)Psychosocial factors
+Failure in examination
+Dowry harrassment
+Marital problems
+Loss of loved ones
+Isolate from social groups
+Financial & occupational difficulties
12. Risk factors
• 1-Marital status
+The suicide rate for single
person is twice then that of
married person.
+Divorced, Separated or Widow
person have rates four to five
times greater then those of
the married.
13. • 2-Gender
+Women attempts suicide more,but men
succeed more often.
+Successful suicide number about 70% for
men & 30% for women.
14. • 3-Age
+Suicide risks & age are positively
correlated this is particularly true with
men.
+Although rates among women remain fairly
constant throughout life.
+The suicide rate among young people age
between 15 to 19 is higher.
15. • 4-Religion
+Suicide rate among Roman catholic population
have been lower then rates among Protestants
& Jews.
17. • 6-Other risk factors
+More than 90% of people who kill themselves
have diagnose mental disorder.
+Several studies have indicated a higher risk
factor for suicide among LGBT community.
+Higher risk is also associated with a family
history of suicide.
18. Classification
• 1- EGOISTIC SUICIDE
+It results from too little social integration.
+Individuals who are not sufficiently bound to
social groups are left with less social support and
guidance and therefore tended to commit suicide on
an increased bases.
+Example- Elderly who has lost their job as well as
family and community bond.
19. • 2- ALTRUISTIC SUICIDE
+It results from too much integration.
+Individuals are so much integrated into social
groups that they lose sight of their
individuality and become wiling to sacrifice
themselves to serves their group interest.
+Example- Sati sahagamana which was followed in
ancient India.
20. • 3- ANOMIC SUICIDE
+Occurs in response to the change that
occurs in an individual life.
+Example- Divorce, bankruptcies
21. • 4- SAMSONIC SUICIDE / SUICIDE OF REVENGE
+To spite others or experiencing as being
unfriendly.
+Example- If the husband is unfaithful to
his wife. She may attempt to commit suicide
to take revenge from him.
22. Management
•1) Be aware of certain
sign which may indicate
that the individual may
commit suicide such as-
Suicidal threat,
Writing farewell
letters, appearing
peaceful & happy after
a period of depression.
23. • 2) Monitoring the patient safety needs
+∆ Take all suicidal threat or attempt
seriously & notify psychiatrist.
+∆ Search for toxic agent such as drugs/
alcohol.
+∆ Do not leave the drug tray with in reach
of patient.
+∆ Remove sharp instruments such as razor
blades, knifes, glass bottles from his
environment.
+∆ Remove clothings such as belt.
24. ∆ Patient should be kept in constant
observation & should never be left alone.
∆ Spend time with him, talk to him
∆ Encourage him to talk about his suicidal
plan.
∆ If suicidal tendencies are very severe,
sedation should be given as prescribed.
25. • Management of attempted suicide in the
inpatient unit-
• ∆ Assess for vital signs,check airway,if
necessary clear airway.
• ∆ If pulse is weak , start IV Fluids.
• ∆ Turn patient head & neck to one side
to prevent regargitation & swallowing of
vomitus.
• ∆ Emergency measures to be institutional
in case of self inflicted injuries.