Orientation for New Child and Adolescent Psychiatry Residents: Module Two - Assessment

Transcription

1 Orientation for New Child and Adolescent Psychiatry Residents: Module Two - Assessment Objectives: To describe important aspects of emergency evaluations of children and adolescents.

2 Steps to Completion 1. Read the Practice Parameter for the Assessment and Treatment of Children and Adolescents with Suicidal Behavior in your Orientation packet. 2. Print the Module Two quiz. 3. Complete the quiz 4. Turn the quiz in to Dorothy Winkler

3 Quiz Question One Approximately US adolescents commit suicide each year. a. 500 b c. 20,000 d. 50

4 Quiz Question Two More than of adolescents who commit suicide suffered from an associated psychiatric disorder at the time of their death. a. 90% b. 50% c. 25% d. 10%

5 Quiz Question Three High-risk factors for suicide in adolescents include: a. Male sex b. Mood disorder c. Previous attempt d. Agitation e. All of the above

6 Quiz Question Four Psychiatric evaluation is required before discharge of a child or adolescent suicide attempter from the ER with which of the following factors? a. Prior attempt b. Male c. Severely anxious d. Irritable e. All of the above

7 Quiz Question Five A child or adolescent being assessed for suicidality in an ER can provide all the important information to make a reasonable assessment and there is no need to burden parents or guardians with intrusive questions about their child s suicidal behavior. a. True b. False

8 Quiz Question Six Which of the following statements is NOT true? a. Likelihood of compliance with follow-up is not affected by the interaction between the family of a suicidal child or adolescent and the emergency room personnel. b. The no-suicide contract can be used as a probe to understand the patient s and family s ability to institute change but the efficacy of a contract has not been empirically studied. c. Self-administered suicide scales are useful for screening normal, high-risk, and patient populations but cannot substitute for a clinical assessment. d. The child or adolescent who has attempted suicide should be hospitalized if his or her unstable condition makes behavior unpredictable, indicating at least short-term serious risk.

9 Quiz Question Seven Which of the following criteria must be met at least 75% of the time before a child an be discharged from the emergency room after assessment of suicidality? (more than one answer may be correct) a. The parent or guardian has verified the child s account of the situation. b. The parent or guardian has agreed to remove or secure firearms or lethal medications. c. A Tatman Suicidal Probability Scale has been completed by the child. d. The parent or guardian assures that a supportive adult will be available to the child at home. e. A follow-up appointment has been made for the child. f. Specific situations that might promote further suicidal behavior such as substance abuse have been discussed with the family. g. Arrangements have been made to engage the family in family therapy as soon as possible.

10 Quiz Question Eight A practitioner may start an adolescent on fluoxetine in the ER after a suicide attempt accompanied by major depression even if follow-up is uncertain. a. True b. False

11 Quiz Question Nine Which of the following is an evidence based appropriate prevention strategy? a. Crisis hotlines b. Reducing access to firearms by gun security laws. c. Classes for high school students about suicide. d. Screening adolescents for previous suicide attempts, suicidal preoccupations, depression, or substance abuse and subsequent evaluation of identified youth.

12 Quiz Question Ten After a peer commits suicide, the following is NOT true for adolescents: a. The risk of major depression, anxiety disorder, suicidal ideation, and PTSD is increased for the first 6 months b. Major depression and PTSD can persist for three years in adolescents who spoke to a friend the day before the friend s suicide. c. There may be an increased risk for suicide contagion especially if media coverage is extensive and prominent. d. Clinicians should avoid discussing the suicide with adolescents who feel guilty about the death.