1. The document discusses suicide and mood disorders, noting that 90% of suicide victims have an underlying major mental disorder like major depressive disorder, substance use disorder, or schizophrenia. 2. It outlines the SAD PERSONS scale for predicting suicide risk factors and describes how to approach a patient who has attempted or is considering suicide, including asking about plans, access to lethal means, and current mental state. 3. Key factors that influence suicide risk are a person's mood, suicidal thoughts or plans, access to lethal means, and whether their situation or outlook could change.

1. SUICIDE & MOOD DISORDER NOOR HAFIZAH BINTI HASSAN 2007287236

2. REFERENCES Suicide risk in mood disorders, Zoltan Riehmer, Curr Opin Psychiatry. 2007;20(1):17-22 . 2. Principle of suicide risk assessment How to interview depressed patient and tailor treatment Richard L. Frierson, Margaret Melikian, Peggy C. Wadman Postgrad Med 2002;112(3):65-71

3. DEFINITION SUICIDE: self-inflicted death with evidence that the person intended to die SUICIDE ATTEMPT: self-injurious behavior with nonfatal outcome with intention of dying SUICIDAL IDEATION: thoughts of wanting to die; seriousness varies Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry 5 th edition

4. WHY BOTHER ? 90% of suicide victims & attempters  1 current axis 1 major mental disorder (mainly untreated) Major Depressive Episode (MDE) : 56-87 % Substance Use Disorder : 26-55 % Schizophrenia : 6-13 % “ state-dependent” phenomenon: During MDE: 78-89 % Dysphoric Mania: 11-20 % Euphoric Mania / Euthymia: 0-7 %

6. PREDICTING RISK FACTORS SAD PERSONS (Patterson and colleagues)

7. SCORE

9. APPROACHING SUICIDAL PATIENT What was the precipitant for the event? Was it planned? What was the method of self harm? Did you leave a suicidal note? Was you alone at the time of event? Was you intoxicated? Did you seek any precautions against discovery? Did you seek help after the attempt? How did you feel when you was found? HISTORY OF PRESENT ILLNESS

10. EXTENT OF SUICIDAL IDEATION When did you begin to have suicidal thoughts? Did any event precipitate the suicidal thoughts? How often do you think about suicide? How much control do you have over your suicidal ideas? Do you regard yourself as a burden, or that your life isn’t worth living? What makes you feel better : contact with family member/use of substance What makes you feel worse? Do you have a plan to end your life? What stops you from killing yourself?

11. PLANS FOR FURTHERANCE AND LETHALITY Do you own a gun or access to firearms? Do you have access to potentially harmful medications / drugs? Have your imagined your funeral / how people will react to your death? Have you practiced your suicide; put gun to head / held meds in hands Have you change your will / life insurance policy / give away your possessions?

12. ASSESS CURRENT SITUATION If you are to going to the same situation again, has anything change? Outlook on the future