Welcome back to MasterUSMLE! Today, we’re covering a high-yield psychiatry topic—suicide risk assessment, a must-know for Step 2 CK.

Let’s set the scene: A 19-year-old college student presents to the campus health center for worsening depression. She recently started an SSRI, feels fatigued, and is struggling socially. When asked about suicidal thoughts, she says she sometimes wonders what life would be like if she were gone. While reviewing her history, you find that two years ago, she attempted suicide by overdosing on painkillers.

Now, here’s your USMLE-style question:

👉 What’s the strongest risk factor for suicide in this patient?

The answer? A prior suicide attempt.

This is the single biggest predictor of future suicide. Past behavior is the best indicator of future behavior—stronger than depression, family history, or even current suicidal thoughts.

Other Risk Factors to Know:

Psychiatric disorders—depression, bipolar, schizophrenia

Substance use—increases impulsivity

Social isolation & hopelessness

History of trauma or abuse

Access to lethal means (e.g., firearms, medications)

Key Takeaway

Always ask about past suicide attempts. If a patient has a history of one, the risk for another is high. Immediate psychiatric evaluation and safety planning are essential.

That’s it for today! Subscribe, share, and keep mastering the USMLE. See you next time!