Calliess I T, Machleidt W, Ziegenbein M, Haltenhof H
Medizinische Hochschule Hannover, Abteilung Sozialpsychiatrie und Psychotherapie, Honnover.
Fortschr Neurol Psychiatr. 2007 Nov;75(11):653-64. doi: 10.1055/s-2007-980057. Epub 2007 Jul 3.
Due to increasing immigration in Germany the German Mental Health Care System today has to deal in a growing number with the assessment of the level of psychic functioning and the capability of self control in patients of different ethnic origin. For clinicians this is a challenge, since suicidal behaviour in terms of its frequency, meaning, motives and manner is very much dependent on the cultural context in which it occurs. Moreover, the general attitude of an individual towards suicide is embedded in the culture of origin of the immigrant. Until now there has been only little systematic research on the influence of culture on suicidal behaviour. In this review the traditions of suicidal behaviour in different cultures in their religious and historical dimensions will be reflected. The historical and cultural roots of suicidal behaviour will be put in context to a categorization of the different variants of suicide, such as institutionalized suicide versus individualized suicide. Psychodynamic aspects of suicidal ideation will be highlighted in cross-cultural perspective with a distinction between a. the wish to die, b. the wish to kill and c. the wish to be killed. It will be shown that there can be differentiated between accepted and non-accepted suicide. With respect to epidemiology there will be discussed the impact of culture on the suicide rates across cultures. The influence of culture on the psychopathology of suicidal behaviour will be summed up systematically. These aspects are of high relevance for the understanding and assessment of suicidal crisis in immigrants, since the suicidal patient even today - although subconsciously - is influenced by the deep rooted traditions of suicidal behaviour in his culture of origin.
由于德国移民数量不断增加，德国精神卫生保健系统如今不得不越来越多地应对对不同种族背景患者的心理功能水平和自我控制能力的评估。对于临床医生来说，这是一项挑战，因为自杀行为在其频率、意义、动机和方式上很大程度上取决于其发生的文化背景。此外，个体对自杀的总体态度植根于移民的原生文化。到目前为止，关于文化对自杀行为影响的系统性研究还很少。在这篇综述中，将从宗教和历史维度反映不同文化中自杀行为的传统。自杀行为的历史和文化根源将与自杀不同变体的分类相结合，如制度化自杀与个体化自杀。自杀观念的心理动力学方面将从跨文化视角进行突出强调，区分a. 想死的愿望，b. 想杀人的愿望，c. 想被杀死的愿望。将表明可以区分被接受的自杀和不被接受的自杀。在流行病学方面，将讨论文化对不同文化中自杀率的影响。将系统总结文化对自杀行为心理病理学的影响。这些方面对于理解和评估移民中的自杀危机具有高度相关性，因为即使在今天，自杀患者——尽管是潜意识地——仍受到其原生文化中根深蒂固的自杀行为传统的影响。
