Suicidal Thoughts (cont.)
Exams and Tests
The assessment of people with suicidal thoughts is far from an exact science.
- If a person is evaluated by the primary health-care professional, he or she may be instructed to go immediately to the emergency department for further evaluation.
- If evaluated in the emergency department, the emergency doctor may enlist the help of a psychiatrist for more expert diagnosis and treatment.
The assessment, whether in the medical office or emergency department, includes the following parts.
Medical interview: A person who is having thoughts of suicide is interviewed extensively by medical professionals. Questions will look for warning signs that a suicide attempt is imminent, such as the following:
- Have you swallowed any medications or drugs?
- What plan do you have for ending your life?
- What circumstances in your life brought you to the point of suicide?
- Have you ever attempted suicide in the past?
- What is your family history of
emotional problems or suicide, if any?
- Have you used alcohol or drugs?
- Have you recently experienced any emotional loss (such as the death of a loved one or a divorce)?
- Do you have any medical illnesses or history of surgery?
- Are you currently taking any herbal, over-the-counter, or prescribed medications?
Mental status: A crucial part of the history is the mental status examination.
- This is a formalized series of questions and commands designed to point toward any psychiatric or neurologic problems, such as depression or schizophrenia.
- The questions may seem silly or insultingly easy, but they are designed to highlight disordered thinking and disorientation that could signal mental illness.
Physical examination: The medical professional performs a head-to-toe physical examination to look for a medical problem, particularly one that could contribute to the person having suicidal thoughts.
- The person's strength, sensation, coordination, reflexes, and ability to walk and balance are checked.
- Depending on the person's age and health status, this may take anywhere from a few minutes to over 20 minutes.
- Any abnormalities may require further evaluation because certain disease states and certain medications can actually cause depression and lead to suicidal thoughts.
Lab tests: The decision to order lab tests is based on the findings of the interview and physical examination.
- No lab test is available for depression, and no lab test is available to tell if someone is serious about committing suicide.
- Any suggestion of medical illness, drug or alcohol intoxication or overdose, or poisoning usually mandates lab tests.
- Blood and/or urine may be checked for drug and alcohol levels.
In some cases, x-ray films, CT scans, or ECGs
may be ordered.
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