title: The importance of the complete history in the discovery of a potential suicide: a case report.
abstract: Suicidal ideation and completed suicides are an increasing problem among the elderly. In 1992, the elderly accounted for 13% of the population but represented 20% of all completed suicides. There are recognized risk factors for suicides in elderly patients, which include depression, deteriorating physical health, and loss of independent functioning. A complete history enables the examiner to establish a relationship with the patient and to formulate a diagnosis. Unfortunately, histories are often incomplete. Many factors can account for this, including financial pressures, patient volume, and overspecialization. The physiatric history is the integration of many parts. It incorporates not only the physiatrist's evaluation but those of other disciplines as well, for example, physical and occupational therapy. The physiatric history is a sensitive tool for assessing the state of being of the whole patient. We describe a case in which a careful and complete physiatric history and physical examination revealed an elderly patient with suicidal ideation and a plan.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, PA, USA. carter.adam@att.net
authors.forename: Adam C
authors.initials: AC
authors.lastname: Carter
authors.forename: John J
authors.initials: JJ
authors.lastname: Nicholas
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000588:Amines; D000701:Analgesics, Opioid / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D048909:Diabetes Complications; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D007871:Leg Ulcer / Q000150:complications / Q000628:therapy; D035002:Lower Extremity / Q000503:physiopathology; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010148:Intractable Pain / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D018805:Sepsis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D013406:Suicide, Attempted / Q000517:prevention & control*; D005680:gamma-Aminobutyric Acid
chemical_list: D000085:Acetates; D000588:Amines; D000701:Analgesics, Opioid; D014151:Anti-Anxiety Agents; D000900:Anti-Bacterial Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D009020:Morphine; D005283:Fentanyl