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Managing Suicide Attempts: Guidelines for the Primary Care Physician

Catherine Goertemiller Carrigan, M.D., M.B.A., and Denis J. Lynch, Ph.D.

The management of patients who have made suicide attempts is a responsibility that frequently falls to the primary care physician. For this reason, it is important that the physician have a clear strategy for dealing with the suicidal patient in the office, hospital, and emergency room. In the acute situation, the first priority is to stabilize the patient and ensure his or her medical safety. Once this is accomplished, history and circumstances of the attempt can be assessed, along with likelihood of recurrence of the attempt. This article reviews guidelines for evaluating suicide risk. The importance of the patient-physician relationship is noted, particularly in regard to prevention of future suicide attempts. With a focused, thorough approach to the suicidal patient, which incorporates both medical and psychiatric considerations, the primary care physician can ameliorate the patient's acute situation and facilitate the coordination of care with appropriate psychiatric resources.

(Primary Care Companion J Clin Psychiatry 2003;5:169-174)

Received May 2, 2003; accepted Aug. 4, 2003. From the Department of Family Medicine, The Medical College of Ohio, Toledo.

In the spirit of full disclosure and in compliance with all ACCME Essential Areas and Policies, the faculty for this CME activity were asked to complete a full disclosure statement. The information received is as follows: Drs. Carrigan and Lynch have no significant commercial relationships to disclose relative to the presentation.

The authors acknowledge valuable suggestions made by Ronald McGinnis, M.D.; Angela Walter, M.D.; and Allan Wilke, M.D.

Corresponding author and reprints: Catherine Goertemiller Carrigan, M.D., M.B.A., 3700 Forest Trail, Findlay, OH 45840