Saccomani L, Matricardi A, Savoini M, Cirrincione M
Divisione e Cattedra di Neuropsichiatria Infantile, Istituto Giannina Gaslini, Genova.
Minerva Pediatr. 1992 Nov;44(11):525-32.
Some data from the literature on adolescent suicidal behaviour are reported: incidence, employed methods, warning signs, risk factors, some psychodynamic aspects. The purpose of this work is to contribute to the study on this matter by a research on 33 adolescents (12 males, 21 females: mean age 14 years, range 11.2-17 years) examined because of suicidal behaviour. The study method includes: anamnesis, psychodiagnostic inquiry, family and environmental investigation, psychiatric evaluation. Suicidal behaviour is characterized by low levels of determined self-elimination intent ("suicidal gestures") in 36% of cases (1 male, 11 females). Relapses are found in 35% of cases, with death in 1 case. The most frequently used methods is drug poisoning (65%). Most common place where suicidal behaviour takes place is at home (82%). Most show warning signs especially verbal threats. Some problem in the family situation (conflicts in the parental couple or between parents and children, psychopathologic disturbances in the parents) and frequent difficulties in school and social adjustment are evident. In 45% a depressed state was noted, in the other cases several psychopathologic disturbances have been found: hysteric neurosis, borderline personality, psychosis. In 30% of cases symptoms coexist with a self-injuring meanings (nervous anorexia, pseudo-epileptic seizures). Prevalent psychodynamic characteristics are: vulnerability in facing frustrating situations and research of support from inadequate parental figures: displacement from hetero-direct aggressive drives to an expiratory or revengeful self wounding behaviour. Some criteria for an emergency care and for a middle to long term treatment are mentioned, and the opportunity for collaboration between pediatricians and psychotherapists is suggested.
发病率、使用的方法、警示信号、风险因素以及一些心理动力学方面的内容。这项工作的目的是通过对33名因自杀行为接受检查的青少年（12名男性，21名女性：平均年龄14岁，范围11.2 - 17岁）进行研究，为该问题的研究做出贡献。研究方法包括：问诊、心理诊断询问、家庭和环境调查、精神科评估。自杀行为的特征是在36%的病例（1名男性，11名女性）中存在低水平的明确自我消除意图（“自杀姿态”）。35%的病例出现复发，1例死亡。最常使用的方法是药物中毒（65%）。自杀行为最常发生的地点是在家中（82%）。大多数人表现出警示信号，尤其是言语威胁。家庭状况中存在一些问题（父母夫妻之间或父母与子女之间的冲突、父母的精神病理障碍）以及在学校和社交适应方面频繁出现困难是明显的。45%的人存在抑郁状态，在其他病例中发现了几种精神病理障碍：癔症性神经症、边缘型人格、精神病。30%的病例症状伴有自我伤害的意义（神经性厌食、假性癫痫发作）。普遍的心理动力学特征是：面对挫折情境时的脆弱性以及从不适当的父母形象寻求支持：将异性直接攻击驱力转移为呼气或报复性的自我伤害行为。提到了一些紧急护理和中长期治疗的标准，并建议儿科医生和心理治疗师之间进行合作的机会。
