Tsai Chia-Fen, Tsai Shih-Jen, Yang Cheng-Hung, Hwang Jen-Ping
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Int J Geriatr Psychiatry. 2007 Nov;22(11):1106-9. doi: 10.1002/gps.1795.
Suicide attempt is rarely reported in dementia. This study explores the clinical and phenomenological aspects as well as the treatment of Chinese demented patients who have attempted suicide.
During a 1-year period, demented patients admitted to a geropsychiatric unit as a result of suicide attempt were investigated for factors related to suicide attempt, such as motives and method.
In this 1-year survey, seven demented patients (11.7% of all demented patients) were admitted immediately following a suicide attempt. All seven patients had mild or moderate dementia. Three had significant clinical depression symptoms on admission. In all patients, delusions were the primary cause of suicide attempt. Their suicidal ideations were improved with antipsychotic and antidepressant treatment.
These cases, taken together, suggest that suicide attempt can occur in patients with dementia. It is important for clinicians to be aware of the risk of suicide in patients with dementia, especially those associated with delusions, even if they have no major depression or suicide attempt history. Antidepressants and antipsychotics may play a critical role in the treatment of suicide attempt in dementia.
痴呆患者中很少有自杀未遂的报道。本研究探讨了有自杀未遂行为的中国痴呆患者的临床和现象学特征以及治疗方法。
在1年的时间里，对因自杀未遂而入住老年精神科的痴呆患者进行调查，以了解与自杀未遂相关的因素，如动机和方法。
在这1年的调查中，7名痴呆患者（占所有痴呆患者的11.7%）在自杀未遂后立即入院。所有7名患者均患有轻度或中度痴呆。3名患者入院时伴有明显的临床抑郁症状。在所有患者中，妄想是自杀未遂的主要原因。抗精神病药物和抗抑郁药物治疗后，他们的自杀意念得到改善。
总体而言，这些病例表明痴呆患者可能会出现自杀未遂行为。临床医生应意识到痴呆患者的自杀风险，尤其是与妄想相关的风险，即使他们没有重度抑郁或自杀未遂史。抗抑郁药和抗精神病药在痴呆患者自杀未遂的治疗中可能起着关键作用。
