Chapter 116

Management of the Suicidal Patient

Glenn A. Melvin

Glenn A. Melvin

New York State Psychiatric Institute, New York, NY, USA

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Kelly Posner

Kelly Posner

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

New York State Psychiatric Institute, New York, NY, USA

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Barbara H. Stanley

Barbara H. Stanley

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

New York State Psychiatric Institute, New York, NY, USA

John Jay College of Criminal Justice, City University of New York, New York, NY, USA

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Maria A. Oquendo

Maria A. Oquendo

Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

New York State Psychiatric Institute, New York, NY, USA

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First published: 16 April 2008
Citations: 1

Summary

Management of the suicidal patient is a challenging clinical task, yet a core competency in psychiatry. Assessing suicidal risk requires rapport, and aims to determine diagnosis, demographic and clinical risk and protective risk factors. Treatment approaches to suicidal ideation and behavior (suicidality) focus on management of the underlying disorder or direct treatment of the suicidality. Few treatments have empirical support for the management of suicidality. Of the pharmacological treatments, lithium and clozapine have evidence of efficacy as do the psychotherapies cognitive behavioral therapy and dialectical behavior therapy. Newer antidepressants have been associated with reduced suicide rates.

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