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Suicidal Patient in Sub-Saharan Africa.

Patient details
Patient details.
Patient: J, a 22-year-old man from a rural village in Zambia.
Patient case fields
Presentation

J was brought to the emergency department by his brother after he attempted to take his own life by ingesting pesticide. His brother found him unconscious in their family’s field and rushed him to the nearest clinic. J had been struggling with feelings of hopelessness and worthlessness for months but had not sought help due to the stigma surrounding mental health in his community. He had recently lost his job and felt a growing burden of financial pressure, which worsened his emotional state. 

History

J had no known history of mental illness, though his brother mentioned that J had become withdrawn, irritable, and had stopped socializing in recent months. He had been experiencing insomnia, loss of appetite, and frequent headaches. There was no history of substance abuse, but he had isolated himself from family and friends, expressing a sense of failure over his inability to provide for his family.

Examination

On arrival, J was semi-conscious and required immediate medical attention to manage the pesticide ingestion. His vital signs were unstable, and he was treated for pesticide poisoning with activated charcoal and supportive care. Once stabilized, a psychiatric evaluation was conducted, revealing profound feelings of guilt, worthlessness, and recurrent suicidal thoughts.

Diagnosis

Major Depressive Disorder with acute suicidal ideation and a recent suicide attempt

Management

J was admitted for medical stabilization and psychiatric care. He was placed on suicide watch and received counselling from a mental health professional. His family was educated about the signs of depression and how to support him. A long-term plan was developed, including antidepressant therapy, continued counselling, and regular follow-up with a mental health worker. Efforts were made to connect him with community support and vocational training opportunities to address his financial concerns.

Outcome

After several days in the hospital, J showed gradual improvement in his mental state. His suicidal thoughts lessened, and he began to engage in therapy. A follow-up plan was arranged, with continued counselling and support from his family and community health workers to monitor his progress and prevent relapse.

Discussion
No data was found
Questions
1. What was the primary method of J's suicide attempt?

   A). Overdosing on medication

   B). Ingesting pesticide

   C). Hanging

   D). Cutting

2. What was a major contributing factor to J’s emotional distress?

   A). Substance abuse

   B). Financial pressure after losing his job

   C). Chronic physical illness

   D). A recent breakup

3. What immediate medical intervention was given to J after his suicide attempt?

   A). Blood transfusion

   B). Dialysis

   C). Activated charcoal for pesticide ingestion

   D). Surgery

4, What was part of J's long-term management plan?

   A). Hospitalization for several months

   B). Antidepressant therapy, counseling, and community support

   C). Isolation to avoid stress

   D). Physical therapy and pain management

Reveal answers

Answers

  1. B) Ingesting pesticide
  2. B) Financial pressure after losing his job
  3. C) Activated charcoal for pesticide ingestion
  4. B) Antidepressant therapy, counseling, and community support