Evidence-Based Psychiatric Medicine: Lithium for Suicide Prevention

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The Problem

You are working in one of America's contemporary long-term psychiatric care facilities, also known as the state prison. One of your patients suffers from some type of affective instability because of a primary mood disorder, an Axis II disorder, or a combination of both.

It is difficult to diagnose accurately as the inmate/patient provides a somewhat unreliable history, collateral data are not available or of questionable credibility, and records are either unavailable or in shambles.

The patient has a history of what might be suicide attempts or self-injurious behaviors, though again, it is difficult to tell for similar reasons. You consider prescribing lithium to target affective instability and possible suicide prevention.

The Question

How effective is lithium in preventing suicidal behavior? …