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精神分裂症患者自杀风险的评估与治疗

Assessment and treatment of suicide risk in schizophrenia.

作者信息

Pompili Maurizio, Lester David, Innamorati Marco, Tatarelli Roberto, Girardi Paolo

机构信息

Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, 00189 Roma, Italy.

出版信息

Expert Rev Neurother. 2008 Jan;8(1):51-74. doi: 10.1586/14737175.8.1.51.

Abstract

Schizophrenic patients at risk of suicide are more likely to be young, male, white, never married, with post-psychotic depression, and a history of substance abuse and suicide attempts. Hopelessness, social isolation, awareness of illness and hospitalization are also related to suicide risk. Deteriorating health with a high level of premorbid functioning, recent loss or rejection, limited external support, family stress or instability are other features that have been reported in schizophrenic patients who commit suicide. Atypical antipsychotics, especially clozapine, have emerged as important tools in the therapeutic armamentarium. Psychosocial intervention and psychotherapy may play an important role in the management of suicide risk, especially if such interventions help the patient face daily difficulties, loneliness and conflicts inside the family.

摘要

有自杀风险的精神分裂症患者更可能是年轻、男性、白人、未婚,伴有精神病后抑郁,有药物滥用和自杀未遂史。绝望、社会隔离、对疾病的认知以及住院治疗也与自杀风险有关。病前功能水平较高但健康状况恶化、近期有丧失或被拒绝的经历、外部支持有限、家庭压力或不稳定是自杀的精神分裂症患者报告的其他特征。非典型抗精神病药物,尤其是氯氮平,已成为治疗手段中的重要工具。心理社会干预和心理治疗可能在自杀风险管理中发挥重要作用,特别是如果这些干预措施能帮助患者面对日常困难、孤独以及家庭内部冲突。

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