Preventive activities in general practice 7th edition

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Screening tests of unproven benefit

Appendices

Disclaimer

Suicide

Suicide age range table

Age

0 - 9

10 - 14

15 - 19

20 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 - 69

70 - 79

>80

There is a lack of evidence for the routine screening of patients using a screening instrument (C). General practitioners should be alert for higher risk individuals and the possibility of suicide in patients at higher risk. There is evidence that detecting and treating depression has a role in suicide prevention.^442,443 For example, the incidence of suicide has decreased in older men and women in association with exposure to antidepressants.⁴⁴⁴

Suicide risk
Who is at higher risk of suicide?	What should be done?	How often?	Level of evidence and references
Average risk General population	No routine screening for suicide	N/A	III C 445,446
Increased risk Attempted suicide is a higher risk in the following: those with a mental illness, especially mood disorders, alcohol and drug abuse previous suicide attempts or deliberate self harm males young people those with a recent loss or other adverse event patients with a family history of attempted or completed suicide Aboriginal people and Torres Strait Islanders those who are widowed those living alone or in prison those with a chronic and terminal medical illness	Evaluate risk for suicide	When risk factors present and with all patients aged 14–24 years	III VC 54,442,445

Suicide risk

Who is at higher risk of suicide?

What should be done?

How often?

Level of evidence and references

Average risk

General population

No routine screening for suicide

N/A

III C 445,446

Increased risk

Attempted suicide is a higher risk in the following:
- those with a mental illness, especially mood disorders, alcohol and drug abuse
- previous suicide attempts or deliberate self harm
- males
- young people
- those with a recent loss or other adverse event
- patients with a family history of attempted or completed suicide
- Aboriginal people and Torres Strait Islanders
- those who are widowed
- those living alone or in prison
- those with a chronic and terminal medical illness

Evaluate risk for suicide

When risk factors present and with all patients aged 14–24 years

III VC 54,442,445

Suicide test
Test	Technique	References
Evaluate the risk of suicide in the presence of risk factors	How has your mood been lately? Has anything been troubling or worrying you? Have you had times when you have been feeling sad or ‘down’? Have you ever felt like life is just getting on top of you? Do you sometimes wish you could just make it all stop, or that you could just end it? Have you thought about how you might do this? Have you ever wished you were dead? Have you ever thought about taking your own life? Patients with suicidal ideation should be questioned regarding preparatory actions, eg. obtaining a weapon, making a plan, putting affairs in order, giving away prized possessions, preparing a suicide note	86,447
Screening for psychological distress with young people	The following questions might be asked: ‘How are you going generally?’ ‘Do you ever feel miserable?’ ‘How are things at home (or where you live)?’ ‘Lots of people use alcohol and drugs, how about you?’	86

Suicide test

Test

Technique

References

Evaluate the risk of suicide in the presence of risk factors

How has your mood been lately?
Has anything been troubling or worrying you?
Have you had times when you have been feeling sad or ‘down’?
Have you ever felt like life is just getting on top of you?
Do you sometimes wish you could just make it all stop, or that you could just end it?
Have you thought about how you might do this?
Have you ever wished you were dead?
Have you ever thought about taking your own life?

Patients with suicidal ideation should be questioned regarding preparatory actions, eg. obtaining a weapon, making a plan, putting affairs in order, giving away prized possessions, preparing a suicide note

86,447

Screening for psychological distress with young people

The following questions might be asked:

‘How are you going generally?’
‘Do you ever feel miserable?’
‘How are things at home (or where you live)?’
‘Lots of people use alcohol and drugs, how about you?’

Guidelines for preventive activities in general practice 7th edition

Full index

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Oral hygiene

Glaucoma

Urinary incontinence

Osteoporosis

Screening tests of unproven benefit

References

Appendices

Glossary

Acronyms

Acknowledgements

Disclaimer

Suicide