Features and Epidemiology

Causes and Prevention

Assessment and Treatment

Features and Epidemiology

Assessment and Treatment

Elderly

Unmarried

White

Male

Living alone

Assess sociodemographic risk factors

“How are things going in your marriage, in your family, at home, at work?” (Cover health, financial, marital, family, legal, and occupational factors)

“Have you experienced sad, blue, or empty feelings and at least two of the following in the past two weeks?”

Trouble falling or staying asleep

Feeling tired or having little energy

Poor appetite or overeating

Little interest or pleasure in doing things

Feeling bad about yourself

Trouble concentrating

Feeling fidgety, restless, or unable to sit still

“Have you felt nervous, anxious, or on edge?”

“Have you had anxiety or panic attacks recently?”

Ask about stressors

Screen for depression and associated anxiety or agitation

“Have you ever felt you should cut down on your drinking?”

“Have people annoyed you by criticizing your drinking?”

“Have you ever felt bad or guilty about your drinking?”

“Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?”

Yes to two or more means probable alcohol abuse.

Screen for alcohol abuse

“Have you had thoughts about death, or about killing yourself?” If yes, ask:

“Do you have a plan for how you would do this?”

“Are there means available (e.g., a gun and bullets or poison)?”

“Have you actually rehearsed or practiced how you would kill yourself?”

“Do you tend to be impulsive?”

“How strong is your intent to do this?”

“Can you resist the impulse to do this?”

“Have you heard voices telling you to hurt or kill yourself?”

Ask about previous attempts, especially the degree of intent.

Ask about suicide of family members.

Assess risk of suicide

Assessment of Suicide