Psychiatry Suicidality: Review Questions William R. Marchand, MD Dr. Marchand is acting chief of psychiatry, George E. Wahlen Veterans Affairs Medical Center, and assistant professor of clinical psychiatry, University of Utah, Salt Lake City, UT. This work was supported by the Veterans Administration VISN 19 MIRECC. Choose the single best answer for each question.
	1. How has the overall suicide rate in the United States changed as a result of recent advances in recognition and treatment of depression and the development of suicide prevention programs? The suicide rate has not changed The suicide rate is unknown The suicide rate has increased The suicide rate has decreased The suicide rate fluctuates regardless of interventions Click here to compare your answer. 2. The vast majority of completed suicides occur in individuals in which of the following categories? Those who have suffered an interpersonal loss Those who have had a significant financial loss Those with diagnosable psychiatric illness Those with terminal illness Those who have suffered a loss of social status Click here to compare your answer. 3. A 35-year-old woman with panic disorder presents to her primary care physician. She reports that her treatment is not working and her panic attacks are becoming more frequent and increasing in severity. She also states that she is feeling discouraged about getting better. How should this patient’s risk of suicide be assessed? Suicide is not associated with panic disorder; therefore, an evaluation is unnecessary Do not ask about suicide because the patient may feel more discouraged Do not ask about suicide because the patient may act on suicidal thoughts Ask the patient if she is having any thoughts of death or suicide Refer the patient to a psychiatrist to evaluate risk of self harm Click here to compare your answer.		4. A 20-year-old man reports symptoms that meet diagnostic criteria for bipolar I disorder. He is currently depressed and reports chronic suicidal ideation. He is in good health and is not currently taking any medications. Which of the following agents would be most appropriate for the treatment of both his mood disorder and suicidality? Carbamazepine Fluoxetine Lithium Quetiapine Valproic acid Click here to compare your answer. 5. A 70-year-old man presents to his primary care physician for routine medical care. During the course of the visit, he reports multiple vague somatic complaints, some difficulty with sleep, low energy, and problems with memory and concentration. He adamantly denies feeling depressed or sad. Based on this information, how would you characterize this patient’s potential suicide risk? No risk Very low High Psychiatric referral is necessary to evaluate suicide risk Unable to assess suicide risk without more information Click here to compare your answer.
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