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自杀性抑郁患者的心理治疗与心理药物治疗

[Psychotherapeutic and psychopharmacological treatment of suicidal depressive patients].

作者信息

Wolfersdorf M

机构信息

Psychiatrische Klinik Weissenau, Abteilung Psychiatrie I, Universität Ulm, Ravensburg.

出版信息

Schweiz Rundsch Med Prax. 1991 Feb 19;80(8):173-7.

PMID:2008553
Abstract

Depressive patients in a high-risk-group due to suicidal behavior and death by suicide. Suicide rates amount to 500 to 900 per 100,000 depressives. According to the literature mortality reaches 15% in all primary depressive patients. Of our own depressive inpatients 20% were admitted because of tentamen. About 29% of our depressive inpatients have attempted ed suicide in former history. Among suicides during psychiatric hospital treatment were significantly more patients with depression than among the entire hospital clientele and inpatients with affective psychoses especially with delusional depression were overrepresented. Hopelessness, higher scores in depression scales, feelings of guilt and worthlessness, delusions seem to differentiate between depressives with and without suicidal behavior. Treatment of these patients means psychotherapeutic measures which can be described in terms of crisis intervention, brief psychotherapy, and antidepressive medication as a treatment of the underlying depression, sometimes in combination with neuroleptics or/and tranquilizers.

摘要

因自杀行为和自杀死亡而处于高风险组的抑郁症患者。自杀率为每10万名抑郁症患者中有500至900人。根据文献,所有原发性抑郁症患者的死亡率达到15%。在我们自己的抑郁症住院患者中,20%是因检查而入院的。我们的抑郁症住院患者中约29%曾有过自杀未遂史。在精神病院治疗期间自杀的患者中,抑郁症患者明显多于整个医院的患者群体,而患有情感性精神病尤其是妄想性抑郁症的住院患者比例过高。绝望、抑郁量表得分较高、内疚和无价值感、妄想似乎可以区分有自杀行为和无自杀行为的抑郁症患者。对这些患者的治疗意味着心理治疗措施,可描述为危机干预、短程心理治疗,以及作为对潜在抑郁症治疗的抗抑郁药物治疗,有时还会联合使用抗精神病药物或/和镇静剂。

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