Psychiatry at a glance - Suicide Risk, NMS, 5-HT Syndrome, Depression

Assesing suicide risk/severity - MAN THIS ISN'T FAIR (Credit: Dr A Sankaranarayanan)

Mental status (eg. depressed, anxious, agitated, guilt/shame, delusions)
Attempts (prev suicide attempts + exploring the lethality if any)
Nothing to live for (e.g. no family support, career, sense of hopelessness)

Trigger (any precipitants for the suicide attempt?)
Help - did patient seek help after the attempt
I=IDEAS and INTENTION (ie. explore suicide plans & confidence level to see it thru)
Substance abuse

Ilness (Medical or Psychiatric)
Suicide in the family
N’T = suicide NOTE (also telling others prior to attempt)

Final arrangements (eg. final goodbyes, leaving a will)
Access to suicide means (e.g., firearms)
Isolation (ie. made efforts to be undiscovered?)
Regret surviving the suicide attempt??


Symptoms of Neuroleptic Malignant Syndrome - FALTER

Fever / Fluctuating consciousness
Autonomic instability
Leucocytosis
Tremor
Elevated CK
Rigidity


Symptoms of Serotonin Syndrome - FiRe My CoFe
(again, a poor mnemonic that has absolutely no link to the clinical condition =P)

Fits
Reflexes increased

Myoclonus

Confusion
Fever


Assessment of Depression - ME ESCAPINGS

Mood (depressed)
Enjoyment (ie. anhedonia)

Energy
Sleep (insomnia or hypersomnia)
Concentration (diminished concentration or indecisiveness)
Appetite (decreased OR increased)
Psychomotor retardation (OR agitation)
IN Guilt (excessive/inappropriate feelings of guilt or worthlessness)
Suicide (recurrent suicidal ideation/attempt)

MDD = >4 symptoms daily for 2/52, one of which has to be part of "ME" (Mood OR Enjoyment)