It is a psychiatric emergency if a patient confides in you that:
A. There are no reasons for him to keep from dying
B. He is having episodes of elation and increased energy
C. He is experiencing free floating anxiety and fear
D. Death and dying is constantly on his mind
ANS: A
Completed suicides occur in 10% to 15% of individuals with bipolar I disorder. Suicide ideation and attempts are more likely in the depressive or mixed state (APA, 2013). Therefore, suicide risk should always be assessed in a psychiatric evaluation. Box 17.12 lists several questions for assessing suicide risk. If the responses identify a detailed plan for ending life, a lack of hope that things can be better in the future, or an inability to identify reasons for not dying (such as not wanting to leave loved ones), it is considered a psychiatric emergency, requiring immediate intervention.
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