Kaye N S, Soreff S M
Medical Center of Delaware, Newark 19713.
Am J Psychiatry. 1991 Jun;148(6):739-43. doi: 10.1176/ajp.148.6.739.
The suicide of a patient is not an infrequent event in a psychiatrist's practice, and it has a major impact on the clinician as well as on the patient's family and the hospital staff. Dealing with a patient's suicide is a neglected topic in residency training, and many psychiatrists are never taught how to cope with such a situation. The authors review the relevant literature and draw on this as well as on their own clinical experience to recommend specific interventions. They point out that the psychiatrist has a leadership role and a number of responsibilities in the aftermath of a suicide, including notifying the family, the hospital staff, hospital officials, and patients who knew the deceased patient; meeting with the family, the staff, and the patients to encourage discussion and venting of feelings; attending the funeral; and accurately documenting events in the medical record. The psychiatrist should also attend to his or her own needs by seeking support from a colleague and should ensure that a psychological autopsy is performed in order to facilitate learning, improve care of patients in the future, and help bring about closure for the psychiatrist so that the quality of his or her care of other patients is not compromised.
在精神科医生的临床工作中，患者自杀并非罕见事件，它对临床医生、患者家属及医院工作人员都会产生重大影响。在住院医师培训中，处理患者自杀是一个被忽视的话题，许多精神科医生从未学习过如何应对这种情况。作者回顾了相关文献，并结合自身临床经验提出了具体的干预建议。他们指出，在患者自杀后，精神科医生应发挥领导作用并承担多项责任，包括通知家属、医院工作人员、医院管理人员以及认识已故患者的其他患者；与家属、工作人员和其他患者会面，鼓励他们进行讨论并宣泄情绪；参加葬礼；以及在病历中准确记录事件。精神科医生还应通过向同事寻求支持来关注自身需求，并应确保进行心理解剖，以便促进学习、改善未来对患者的护理，并帮助精神科医生实现心理上的了结，从而不影响其对其他患者的护理质量。
