Mittal Vikrant, Brown Walter A, Shorter Edward
Department of Psychiatry, Yale University, New Haven, Connecticut, USA.
Psychiatr Serv. 2009 Mar;60(3):384-6. doi: 10.1176/ps.2009.60.3.384.
It has long been taught and believed that patients with depression and suicidal tendencies are at heightened risk of suicide as they begin to recover and their energy and motivation return. What are the data behind this enduring belief? More than a century ago, eminent clinicians noted that some patients with depression committed suicide just as their depression seemed to be improving. The clinicians went on to warn that early recovery carries a high risk of suicide. Although no studies have tracked suicide along with symptomatic change in depression, recent large-scale studies of suicide and phase of treatment do not indicate that suicide is more likely to occur early in recovery than at other times. Our forebears helpfully pointed out that patients with depression may commit suicide as they are beginning to recover. But the idea that these patients are at particular risk of suicide at this time, intuitively plausible as it is, remains to be substantiated.
长期以来，人们一直教导并相信，患有抑郁症和有自杀倾向的患者在开始康复且精力和动力恢复时，自杀风险会升高。这种长久以来的观念背后有哪些数据支撑呢？一个多世纪以前，杰出的临床医生就指出，一些抑郁症患者恰好在其抑郁症状似乎正在改善时自杀了。这些临床医生进而警告说，早期康复伴随着很高的自杀风险。尽管尚无研究追踪抑郁症症状变化与自杀情况，但近期关于自杀与治疗阶段的大规模研究并未表明，自杀在康复早期比在其他时期更有可能发生。我们的先辈们有益地指出，抑郁症患者可能在开始康复时自杀。但认为这些患者在此时特别容易自杀的观点，尽管从直觉上看似乎合理，仍有待证实。
