Review Question - QID 105681

This patient is actively suicidal and should be admitted to the hospital to ensure her safety.

The patient presents with several symptoms of major depression. All depressed patients should be screened for suicidal ideation. Patients who admit to contemplating suicide and have a plan in place for committing suicide are of high risk to actually commit suicide and need to be monitored and treated in a hospital environment.

Gliatto et al. discuss suicidal ideation. Suicidal ideation is common in patients with psychiatric disorders, and such patients will most often present to family physicians rather than psychiatrists. The extent of suicidal ideation, including the presence of a suicidal plan and assessment of a patient’s means to commit suicide, must be determined in all patients.

Kennedy et al. review suicidal ideation in 15-24-year-olds. Patients that do not need to be hospitalized for suicide include those who are not actively suicidal, do not have access to lethal methods, and have a supervising adult who can closely monitor their behavior.

Illustration A is a chart displaying various behaviours that necessitate hospital admission in psychiatric patients.

Incorrect Answers:
Answer 1: The patient is above age 18 and has the right to choose whether her health information should be shared with her parents. Hospitalization is a more urgent next step in the patient’s care.
Answer 3: The patient must decide if she wishes the health center at her college to be informed of her condition. Hospitalization is a more urgent next step.
Answer 4: The patient has several signs and symptoms of depression; hospitalization is a more urgent next step than a depression screening test.
Answer 5: While fluoxetine may be an appropriate long-term treatment for this patient’s depression, hospitalization is a more appropriate next step in management.