Department of Veterans Affairs, New Jersey Healthcare System, Psychiatry Service 116A, East Orange, NJ 070818, USA.
Psychiatr Clin North Am. 2009 Dec;32(4):863-83. doi: 10.1016/j.psc.2009.08.005.
Suicidal behavior remains a major source of morbidity and mortality among schizophrenics. The National Institute of Mental Health Longitudinal Study of Chronic Schizophrenia found that over a mean of 6 years, 38% of the patients had at least one suicide attempt and 57% admitted to substantial suicidal ideation. Suicide is also a major issue among inpatients, with serious implications for clinical practice and patient-doctor relationships. The management of schizophrenic patients with suicide risk remains a difficult area for clinicians despite attempts to better understand it by gathering experts in the field. This article discusses the frequency of suicidal behavior in schizophrenia, offers a model for understanding it, and discusses various aspects of the management of the at-risk schizophrenic patient.
自杀行为仍是精神分裂症患者发病率和死亡率的主要来源。美国国家精神卫生研究所对慢性精神分裂症患者进行的纵向研究发现,在平均 6 年的时间里,38%的患者至少有过一次自杀企图,57%的患者承认有过严重的自杀意念。自杀也是住院患者的一个主要问题,这对临床实践和医患关系有严重影响。尽管通过汇集该领域的专家来试图更好地理解它,但对有自杀风险的精神分裂症患者的管理仍然是临床医生面临的一个难题。本文讨论了精神分裂症患者自杀行为的频率,提供了一种理解它的模型,并讨论了有风险的精神分裂症患者管理的各个方面。