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Gurpal

Part II ISQ Club - DSH

32 posts in this topic

Starting from today, 10 ISQs on each of two topics will be posted twice a week, on Monday and Thursday. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post amd try not to dominate a thread. All ISQs are taken from previous posts by Forum members. By the time of the exam, we should have got through 500 ISQs.

1 Being with a partner increases the risk of repetition of deliberate self harm.

2 Men self-harm more often than women in old age.

3 Men over 65 are more likely to commit suicide than women.

4 Living with a spouse is a risk factor for repeated deliberate self harm.

5 A history of criminal conviction is a risk factor for repeated deliberate self harm.

6 Suicide is commonly associated with physical illness in old age.

7 Carbon monoxide poisoning rarely causes permanent cognitive impairment.

8 Attempted self harm in the elderly is more in men than women.

9 Suicide in the elderly is more common in women.

10 Reducing the availability of means of suicide does not stop suicides in long term.

Click here for links to articles on depression and self-harm/suicide.

Click here for links to relevant websites

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3 Men over 65 are more likely to commit suicide than women.

TRUE

Revision notes in psychiatry - Puri and Hall p423

- the suicide rate in old age is greater in men than in women; men are more likely to use a violent method and to use alcohol.

Examination notes in psychiatry - Buckley, etc p149

-suicide rate for men is higher than women for all age groups. incidence increases with age. 47% of male suicides occur after age50.

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1) False

. A common event prior to a suicide attempt is a serious argument with a partner and disturbed family relationships are found in many cases-. Hawton, K, Fagg, J, Simkin, S, Bale, E and Bond, A, (unpublished) 'Attempted Suicide in Oxford 1995', University Department of Psychiatry, Warneford Hospital, Oxford

but factors found to be associated with attempted suicide are: single marital status (including divorced/widowed)

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2)True ,Men aged over 80 years have a suicide incidence rate six times greater than that of women the same age.

Age groups Numbers and standardised rates of deaths by suicide, 1988*

65-74 yrs:

140 males 44 females

Rate = 27.7,Rate = 7.4

Number and standardised rates of deaths by suicide, 2000*

120 males, 41 females

Rate = 19.2,Rate = 6.1

75-84yrs

82 males 34 females

Rate = 37.8, Rate = 10.2

Number and standardised rates of deaths by suicide, 2000*

77 males, 24 females

Rate = 22.9, Rate = 5.1

85+

20 males, 10 females

Rate = 52.8,Rate = 10.0

Number and standardised rates of deaths by suicide, 2000*

36 males, 6 females

Rate = 45.9, Rate = 3.5

* Rates are expressed as the number of deaths per 100 000 of the estimated resident population. Source: ABS Suicide Data, 1988, 2000

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8)8and9)false  :'(like younger deliberate self-harm attempters, females outnumber males at a raw number ratio of approximately 3:2. However, as there are fewer males surviving into old age the proportionate gender ratio is approximately unity. These ratios contrast with that for completed suicide where men clearly outnumber women. (ox txb psych)

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I am not good at taking the time to go through individual ISQs and match with references. I have always done them off the top of my head. I always get a percentage wrong but I do OK. I got 16 for the ISQs. I hope my way of doing things does not prevent me taking part in the ISQs.

1. F Stabilising factor

2. F? women live longer

3. T

4. F Stabilising factor

5. T Check out MSU/prisons plus increased PD

6. T esp chronic pain/PU/Renal Failure

7. T Have seen a few on call and dont recall cogn imp

8. F? women live longer

9. F more common in men

10 F coal gas/cat converters impact. suicide rates falling

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1. Being with a partner increases the risk of repetition of deliberate self harm.

FALSE. Risk of repetition increased by social isolation

(Page 772,Companion to Psych Studies, Johnstone et al, 6th Ed)

(Page 156, Exam notes in Psych, Buckley et al)

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2. Men self-harm more often than women in old age.

FALSE.

Equal ratio for self harm; male > female for suicide(Page 739,Companion to Psych Studies, Johnstone et al, 6th Ed)

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3. Men over 65 are more likely to commit suicide than women.

TRUE

(Page 739,Companion to Psych Studies, Johnstone et al, 6th Ed)

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4. Living with a spouse is a risk factor for repeated deliberate self harm.

FALSE.

Risk of repetition increased by social isolation

(Page 772,Companion to Psych Studies, Johnstone et al, 6th Ed)

(Page 156, Exam notes in Psych, Buckley et al)

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5. A history of criminal conviction is a risk factor for repeated deliberate self harm.

TRUE

(Pages 429&433, Oxford textbook of Psych, 3rd Ed)

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6. Suicide is commonly associated with physical illness in old age.

TRUE

(Page 739,Companion to Psych Studies, Johnstone et al, 6th Ed)

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7. Carbon monoxide poisoning rarely causes permanent cognitive impairment.

TRUE

“…In most cases both neurological & psychological disturbances improve over weeks or months, even where there is early severe disability …a proportion of cases are left with a degree of cognitive impairment which may be permanent”.

(Page 324,Companion to Psych Studies, Johnstone et al, 6th Ed)

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8. Attempted self harm in the elderly is more in men than women.

FALSE.

Equal ratio (Page 739,Companion to Psych Studies, Johnstone et al, 6th Ed)

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9. Suicide in the elderly is more common in women.

FALSE

“Rates for men are roughly twice those for women…” (Page 739,Companion to Psych Studies, Johnstone et al, 6th Ed)

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10. Reducing the availability of means of suicide does not stop suicides in long term.

TRUE

Causes fall in rate, but does not stop suicide as novel means used (Page 425,Oxford textbook of Psych, 3rd Ed)

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7 Carbon monoxide poisoning rarely causes permanent cognitive impairment.

FALSE

CARBON MONOXIDE POISONING

Carbon monoxide poisoning is a frequent event which can result in a wide variety of neurological and psychiatric sequelae such as mental deterioration, gait disturbance, and frontal lobe signs. Up to 40 percent of those who survive have permanent neuropsychiatric complications. Neuropathological findings include necrosis in the globus pallidum and possibly in other regions of cerebral cortex. CT scan findings can include cortical atrophy and low density lesions in the globus pallidus although these findings are often not present. SPECT and PET scans are more sensitive than CT or MRI scans at detecting damage and have reported decreased activity in basal ganglia and patchy diffuse hypoactivity in the cerebral cortex (especially in the frontal cortex) of carbon monoxide poisoning patients.

KS CTP

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Carbon Monoxide poisoning rarely cause permanent cognitive impairment

False- often causes permanent cognitive impairment.

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7 Carbon monoxide poisoning rarely causes permanent cognitive impairment.

False

Ref : Core Psych Pg 412

Follow-up studies suggest that more than 50% of patients suffer permanent personality change or cognitive deficit.

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6)

suicide is commonly associated with physical illness in old age

Conclusions: Many common illnesses are independently associated with an increased risk of suicide in the elderly. The risk is greatly increased among patients with multiple illnesses. These data may help clinicians to identify elderly patients at risk of suicide and open avenues for prevention

Medical Illness and the Risk of Suicide in the Elderly.[Article]

Source: Archives of Internal Medicine. 164(11):1179-1184, June 14, 2004.

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7 Carbon monoxide poisoning rarely causes permanent cognitive impairment

false.

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http://gateway.uk.ovid.com/gw1/ovidweb.cgi?View+Image=00002591-200208240-00039|TT1&S=PDHFFNKHBCNBDN00D&WebLinkReturn=Full+Text%3dL%7cS.sh.58.61%7c0%7c00002591-200208240-00039

this refernce gives you a graph that shows prevelence of physical illness in a group of elderly who committed suicide - still not sure wether that makes suicide in the elderly commonly associated with physical illness - spose so

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attempted suicide in the elderly is more common in men than women t

according to manchester notes yet cant find a paper to support it

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10. Reducing the availability of means of suicide does not stop suicides in long term.

TRUE

Causes fall in rate, but does not stop suicide as novel means used (Page 425,Oxford textbook of Psych, 3rd Ed)

you have got it wrong, and quoting oxford can convince people that this is absolutely right.but it is not so. same book,4th edition states that the ease with which the population as a whole can access lethal methods of self harm may affect the rate of suicide in that pop.

also, restricting methods for self-harm can only decrease the likelihood that suicide occurs. therefore, ans. is false.

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It does say suicide but not suicide rate...so the answer is True.

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