Simon Robert, Gutheil Thomas G
Georgetown University School of Medicine, USA. risimonmd@ aol.com
Psychiatr Serv. 2009 Mar;60(3):387-9. doi: 10.1176/ps.2009.60.3.387.
There is a long-standing belief that patients with depression and suicidal tendencies are particularly vulnerable to suicide when their depression shows signs of improvement. The authors discuss the clinical challenges of distinguishing real from feigned signs of recovery. Whereas genuine clinical improvement is a process, sudden patient improvement is a suspect event. The authors discuss clinical indicators that distinguish the two. They emphasize the importance of gathering corroborating evidence through communications with staff and the patient's family. Suicide risk assessment is necessary throughout the patient's illness and recovery.
长期以来，人们一直认为，抑郁症患者和有自杀倾向者在抑郁症有改善迹象时特别容易自杀。作者讨论了区分真正康复迹象与伪装康复迹象的临床挑战。真正的临床改善是一个过程，而患者突然好转则是可疑事件。作者讨论了区分两者的临床指标。他们强调通过与医护人员和患者家属沟通收集确证证据的重要性。在患者患病和康复的全过程中，自杀风险评估都是必要的。
