Citation

Dubovsky SL, Dubovsky AN. Crit. Care Clin. 2008; 24(4): 857-874.

Affiliation

Department of Psychiatry, University at Buffalo, 462 Grider Street, Room 1182, Buffalo, NY 14215-3098, USA; Psychiatry and Medicine, University of Colorado School of Medicine, 4200 E. 9 Avenue, Denver, CO, USA.

Copyright

(Copyright © 2008, Elsevier Publishing)

DOI

10.1016/j.ccc.2008.05.002

PMID

18929944

Abstract

Suicidal ideation and attempts are common reasons for visits to the emergency department and critical care hospitalizations and a common public health problem. Most patients who make a suicide attempt have a psychiatric disorder, most frequently a mood, psychotic, substance use, or personality disorder. Patients who are at high risk of another attempt and cannot be transferred promptly to a psychiatric service should be managed jointly by the psychiatric and critical care teams with an emphasis on protection of the patient, identification of substance intoxication and withdrawal, making the environment safe, and instituting treatment of the psychiatric disorder. Antidepressants reduce suicide risk but their slow onset of action may make electroconvulsive therapy a desirable alternative for severely depressed patients. Parenteral treatment is possible with benzodiazepines and antipsychotic drugs but not antidepressants.

Language: en