Common Mental Disorders Depression - New Zealand Doctor

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Appendix C: Assessment of suicide risk Suicide assessment Have you had thoughts that life isn’t worth living? Yes No Have you thought of harming yourself? Yes No Are you thinking of suicide? Yes No Have you tried to harm yourself in the past? Yes No If yes, how many times? When was the most recent time? in last day in last week last month longer ago (specify) How often are you having these thoughts? Have you thought about how you would act on these (is there a plan)? (Does this plan seem feasible? Are the methods available? Is it likely to be lethal?) Have you thought about when you might act on this plan? Are there any things/reasons that stop you from acting on these thoughts? Do you know anyone who has recently tried to harm themselves? If any answer is ‘yes’ prompt with: ‘Tell me more about that’ as discussion will help to convey the extent of risk. If a suicide attempt has been made What did you hope would happen as a result of your attempt? (Did they want to die, or end their pain?) Do you still have access to the method used? Yes No Did you use alcohol or drugs before the attempt? What did you use? Do you have easy access to a weapon? Yes No 136 Identification of Common Mental Disorders and Management of Depression in Primary Care
Appendix C Assessment of suicide risk Commentary Consider whether the person is safe to be alone Risk factors include: • definite plan • hopelessness • severe depression • psychotic symptoms • recent discharge from a psychiatric unit • use of alcohol, street drugs, particularly recent escalation • recent suicide attempt • single men: young, older people • homelessness • medical illness • history of childhood abuse • recent suicide attempt by a whänau/family member or a friend. Adapted with permission from: RAPID assessment of patients in distress. In Centre for Mental Health. Mental Health for emergency departments: a reference guide. NSW Department of Health; 2001. A guideline on the ‘Assessment and Management of People at Risk of Suicide’ 162 can be found at http://www.nzgg.org.nz – enter the guideline title into the search box, then select the publication. Identification of Common Mental Disorders and Management of Depression in Primary Care 137
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Identification of Common Mental Dis
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Statement of intent Evidence-based
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Endorsements Te Ao Maramatanga New
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3.6 Clinical features of common men
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List of figures 3.1 When to refer a
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About the guideline Foreword The Ne
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About the guideline Guideline devel
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About the guideline Paediatric subg
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About the guideline Royal New Zeala
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Algorithm 1 Management of depressio
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Algorithm 2a Management of severe d
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Algorithm 2c Management of mild dep
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• limited access to psychiatrists
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Asian peoples About 7% of the New Z
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12-month period amongst adults atte
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Table 1.2 Prevalence of common ment
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1.4 Etiology of common mental disor
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The ‘hopelessness theory’ 94 co
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Sexuality Data from the Christchurc
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Since those who are affected by sui
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2.3 Managing depression: the steppe
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to informed consent. 152 There is a
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3 Recognition and assessment of com
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Chapter 3 Recognition and assessmen
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Good practice points Management of
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Box 4.1 Whänau Ora The concept of
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If the young person/rangatahi/tamar
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Exercise There was insufficient evi
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at any timepoint. Treatment as usua
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5 Recognition and assessment of com
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6 Management of depression in adult
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Chapter 6 Management of depression
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Page 118 and 119: Recommendations continued... Women
Page 120 and 121: during pregnancy, of which up to 6%
Page 122 and 123: Secondary care evidence Based on ev
Page 124 and 125: Advice for women It may be helpful
Page 126 and 127: Social networks appear to be an inf
Page 128 and 129: eastfeeding, or not breastfeeding,
Page 130 and 131: This evidence comprised two recent
Page 132 and 133: There is also some evidence that th
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Page 137 and 138: Chapter 8 Special issues: older adu
Page 145 and 146: 9 Models of care 9.1 Introduction V
Page 147 and 148: Chapter 9 Models of care were reduc
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Page 164 and 165: Appendix D: Assessment tools for co
Page 166 and 167: Anxiety Anxiety is often comorbid w
Page 168 and 169: Appendix F: Self-management resourc
Page 170 and 171: Information about mental disorders
Page 172 and 173: Dysthymia Dysthymia is a chronic lo
Page 175 and 176: Glossary, abbreviations and acronym
Page 181 and 182: References 1. The MaGPIe Research G
Page 183 and 184: References 38. Tse S, Tong K, Hong
Page 185 and 186: References 72. Kendler K, Kuhn J, P
Page 187 and 188: References 107. Halligan SL, Murray
Page 189 and 190: References 143. Dejesus RS, Vickers
Page 191 and 192: References 179. Shaffer D, Scott M,
Page 193 and 194: References 215. Garralda ME, Bowman
Page 195 and 196: References 249. Zwaanswijk M, Verha
Page 197 and 198: References 283. Linde K, Berner M,
Page 199 and 200: References 318. Henkel V, Mergl R,
Page 201 and 202: References 353. Rush AJ. STAR*D: wh
Page 203 and 204: References 386. Ward E, King M, Llo
Page 205 and 206: References 417. Kirsch I, Deacon BJ
Page 207 and 208: References 451. Zigmond AS, Snaith
Page 209 and 210: References 486. Appleby L, Warner R
Page 211 and 212: References 520. Irwin M, Artin KH,
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References 557. Agnew F, Pulotu-End
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www.nzgg.co.nz www.moh.govt.nz
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Common Mental Disorders Depression - New Zealand Doctor

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