Appleby L
Department of Psychiatry, University Hospital of South Manchester.
Br J Psychiatry. 1992 Dec;161:749-58. doi: 10.1192/bjp.161.6.749.
The prevention of suicide requires an understanding of protective as well as risk factors, and the recognition of high-risk groups. Factors which increase the risk in patient populations include previous parasuicide, recent relapse or discharge, features of mental state (depression, psychosis), social circumstances (isolation, unemployment), and demographic characteristics (male sex, young age). Protective factors are under-researched but are likely to lie in the nature of psychiatric care. Consequently, community care may affect suicide by altering the level of protection at critical periods in an episode of illness. The clinical prevention of suicide should therefore be a priority for community services, and the relationship between suicide and mental health care should be researched by a national process of monitoring.
预防自杀需要了解保护因素和风险因素，并识别高危人群。增加患者群体风险的因素包括既往自杀未遂、近期复发或出院、精神状态特征（抑郁、精神病）、社会环境（孤立、失业）以及人口统计学特征（男性、年轻）。保护因素的研究较少，但可能存在于精神科护理的本质之中。因此，社区护理可能通过在疾病发作的关键时期改变保护水平来影响自杀。因此，自杀的临床预防应成为社区服务的优先事项，并且自杀与精神卫生保健之间的关系应由国家监测程序进行研究。
