Skip to content

    Cancer Health Center

    Font Size
    A
    A
    A

    Depression (PDQ®): Supportive care - Health Professional Information [NCI] - Assessment, Evaluation, and Management of Suicidal Patients

    Table 7. Suggested Questions for the Assessment of Suicidal Symptoms in People With Cancera

    Questions Assessment
    a Adapted from Roth et al.[6]
    Most people with cancer have passing thoughts about suicide such as, "I might do something if it gets bad enough." Acknowledge normality by opening with a statement recognizing that a discussion does not enhance risk
    Have you ever had thoughts like that? Any thoughts of not wanting to live or wishing your illness might hasten your death? Level of risk
    Do you have thoughts of suicide? Have you thought about how you would do it? Do you intend to harm yourself? Level of risk
    Have you ever been depressed or made a suicide attempt? History
    Have you ever been treated for other psychiatric problems or have you been psychiatrically hospitalized before getting diagnosed with cancer? History
    Have you had a problem with alcohol or drugs? Substance abuse
    Have you lost anyone close to you recently? (Family, friends, others with cancer) Bereavement

    Management

    In clinical practice, the goal of management of suicidal patients is to attempt to prevent suicide that is driven by desperation due to poorly controlled symptoms. Prolonged suffering due to poorly controlled symptoms can lead to such desperation. Thus, effective symptom management is critical to decrease psychological distress in suicidal cancer patients.[5] Patients close to the end of life may be unable to maintain a wakeful state without high levels of emotional or physical pain. This frequently leads to suicidal thoughts or requests for aid in dying. Such patients may require sedation to ease their distress.

    At times, it may be important to limit access to potentially lethal medications for patients considered at risk for suicide. When potentially lethal medications are limited, it is important to weigh the impact on symptom management against the impact on suicide risk because poorly controlled symptoms may contribute to risk. Furthermore, suicidal patients will often have other means available to complete suicide attempts and these must also be evaluated. Strategies to lessen suicidal risk include frequent contact to reassess suicidal risk and symptom control, as well as regular delivery of limited quantities of medications facilitating rapid dose titration for effective management of poorly controlled symptoms when necessary. For patients receiving parenteral or intrathecal opioids, programmable pumps with limited access to programming and locked, inaccessible cartridges may provide an element of safety.

    1 | 2 | 3 | 4
    Next Article:

    Today on WebMD

    man holding lung xray
    What you need to know.
    stem cells
    How they work for blood cancers.
     
    woman wearing pink ribbon
    Separate fact from fiction.
    Colorectal cancer cells
    Symptoms, screening tests, and more.
     
    Jennifer Goodman Linn self-portrait
    Blog
    what is your cancer risk
    HEALTH CHECK
     
    colorectal cancer treatment advances
    Video
    breast cancer overview slideshow
    SLIDESHOW
     
    prostate cancer overview
    SLIDESHOW
    lung cancer overview slideshow
    SLIDESHOW
     
    ovarian cancer overview slideshow
    SLIDESHOW
    Actor Michael Douglas
    Article