Prasko Jan, Diveky Tomas, Grambal Ales, Latalova Klara
Department of Psychiatry, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010 Sep;154(3):265-73. doi: 10.5507/bp.2010.041.
Suicide is the eighth leading cause of death in adults and the second leading cause of death in the 15- to 24-year-old age group. Suicidal impulses and suicidal behavior result from emotionally unbearable feeling of mental suffering and cognitive narrowing that prevent resolution to experienced stress, that is, in a situation when personal coping mechanisms have failed. Suicide attempts are a frequent cause of hospital admissions, in particular to anesthesiology and resuscitation departments.
Women attempt suicide three times more often than men. Four times more men than women complete suicide. More than 90% of people who complete suicide are diagnosed with severe mental illness and 50% suffer from depression at the time of suicide.
Physicians should be aware of possible suicidal behavior in any patient with mental illness, especially if accompanied by depressive symptoms. The physician should approach the topic of suicide carefully and discreetly, only after a therapeutic relationship with the patient has been established.
Patient protection, usually in the setting of a closed psychiatric ward, is necessary if he or she has a clear plan and means to commit suicide. After the patient's safety is secured, treatment may be initiated. If the patient is treated on an outpatient basis, his/her condition must be carefully monitored.
自杀是成年人死亡的第八大主要原因，也是15至24岁年龄组死亡的第二大主要原因。自杀冲动和自杀行为源于无法承受的精神痛苦情绪和认知狭隘，这些情况会阻碍对所经历压力的解决，也就是说，在个人应对机制失效的情况下。自杀未遂是住院的常见原因，尤其是入住麻醉科和复苏科。
女性自杀未遂的次数是男性的三倍。男性自杀身亡的人数是女性的四倍。超过90%的自杀身亡者被诊断患有严重精神疾病，50%在自杀时患有抑郁症。
医生应意识到任何患有精神疾病的患者都可能存在自杀行为，尤其是伴有抑郁症状时。医生应在与患者建立治疗关系后，谨慎、审慎地探讨自杀话题。
如果患者有明确的自杀计划和手段，通常需要在封闭的精神科病房进行患者保护。确保患者安全后，方可开始治疗。如果患者在门诊接受治疗，必须对其病情进行密切监测。
