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KPSC Staff Nurse - 2017
Mental Health Nursing
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This is one of the commonest conditions associated with a high risk of suicide?

Appeared in: KPSC Staff Nurse - 2017

Explanation

  • Major depressive disorder (MDD) is the most common psychiatric condition associated with a high risk of suicide.
  • The core symptoms of depression, including pervasive sadness, hopelessness, helplessness, and worthlessness, are direct drivers of suicidal ideation.
  • Research and clinical evidence consistently show that a majority of individuals who die by suicide have a diagnosable mood disorder, with MDD being the most frequent.
  • The risk of suicide is particularly high when the acute phase of depression passes and the patient regains enough energy to act on their suicidal plans.

Why Other Options Were Wrong

  • Option A: While drug and alcohol abuse is a major risk factor and frequently co-occurs with mood disorders, major depression is more often the primary underlying diagnosis in suicide cases.
  • Option B: Schizophrenia has a high lifetime suicide risk (5-10%), but it is a much less prevalent disorder in the general population compared to major depression. Therefore, it accounts for a smaller absolute number of suicides.
  • Option D: Suicide during a pure manic episode is rare. The high energy and grandiosity of mania do not typically lead to suicide. The risk in bipolar disorder is highest during depressive or mixed-feature episodes.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Psychiatric conditions and suicide risk as background academic context rather than a clinical decision trigger.
  • Nurses must be vigilant in screening for depression and suicidal ideation in all clinical settings, as depression is a treatable condition and suicide is a preventable outcome.
  • A key nursing responsibility is to conduct a thorough suicide risk assessment, which includes asking directly about thoughts of self-harm, intent, plans, and access to means.
  • What if? If a patient presents with both major depression and alcohol abuse, the suicide risk is not just additive but multiplicative. This comorbidity requires immediate, intensive intervention and a heightened level of safety precautions.
How to Approach the Question
  • First, identify the core of the question: it asks for the 'commonest' condition linked to suicide, not just any risk factor.
  • Evaluate each option based on its prevalence and strength of association with suicide.
  • Recall that mood disorders are the most widespread class of mental illness linked to suicide.
  • Compare the options: While all are risk factors, major depression is far more prevalent in the general population than schizophrenia and is the primary diagnosis in a majority of suicides.
  • Differentiate between the states within bipolar disorder; recognize that risk is highest in depressive or mixed states, not mania.
  • Conclude that Major Depression is the best fit for the 'commonest' condition.
Concept Tested & Keywords
  • Concept Tested: Psychiatric conditions and suicide risk
  • Stem keywords: suicide, high risk, commonest conditions
  • Lead-in keywords: commonest
  • Negative lead-in flag: false

Question ID

Q34fzo0ZEtnMoUVfvmZID0

Reference Book

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 84-86

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8779-8781

E6 Medicine Davidson Principles Practice 24e p. 1218-1220

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