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A 55-year-old man has made a serious attempt at suicide by cutting his throat. He had been depressed for some time and had chronic pain from an osteoarthritic hip, which has prevented him from working as a taxi driver. His wife says that as a result of the loss of income he erroneously believed that he is now bankrupt. After surgical repair of his injury and a period of intensive care, he remains virtually mute, withdrawn and psychomotor retarded. He has stopped eating and drinks only small amounts. His family wish to take him home as they feel the hospital environment is making him worse. Which one of the following is the most appropriate management plan?
(A) Discharge him home on antidepressant medication with daily reviews by his general practitioner and the local mental health crisis team
(B) Admission to a general medical ward, with intravenous fluids, antidepressants and a nursing special around the clock
(C) Continue his stay in the intensive care unit with antidepressants and hyperalimentation and daily liaison psychiatric review
(D) Admission to a psychiatric unit with antidepressant and antipsychotic medication
(E) Involuntary psychiatric hospitalisation for urgent electroconvulsive therapy (ECT)
A 55-year-old man has made a serious attempt at suicide by cutting his throat. He had been depressed for some time and had chronic pain from an osteoarthritic hip, which has prevented him from working as a taxi driver. His wife says that as a result of the loss of income he erroneously believed that he is now bankrupt. After surgical repair of his injury and a period of intensive care, he remains virtually mute, withdrawn and psychomotor retarded. He has stopped eating and drinks only small amounts. His family wish to take him home as they feel the hospital environment is making him worse. Which one of the following is the most appropriate management plan?
(A) Discharge him home on antidepressant medication with daily reviews by his general practitioner and the local mental health crisis team
(B) Admission to a general medical ward, with intravenous fluids, antidepressants and a nursing special around the clock
(C) Continue his stay in the intensive care unit with antidepressants and hyperalimentation and daily liaison psychiatric review
(D) Admission to a psychiatric unit with antidepressant and antipsychotic medication
(E) Involuntary psychiatric hospitalisation for urgent electroconvulsive therapy (ECT)
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