Bertolote José Manoel, Mello-Santos Carolina de, Botega Neury José
Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Braz J Psychiatry. 2010 Oct;32 Suppl 2:S87-95. doi: 10.1590/s1516-44462010000600005.
Guide the health professional to identify risk factors and forms of protection, together with handling such patient throughout a clinical interview within the emergency service context.
Selected literature revision so as to identify relevant and illustrative key cases.
The clinical interview is the best method to evaluate the suicidal risk and has two different aims: 1) emotional support and creation of a bond; 2) collecting information. There is a substantial amount of information to be collected during the clinical interview, such as: risk factors and protection, epidemiologic data, act characterization, psychical dynamics aspects, personal and familial historic patterns, identification models, data on physical wealth and social net support. Difficulties are to emerge throughout the clinical interview, but a trained and informed professional will be able to approach and adequately add the patient. Although several scales have been proposed, none of them have been efficient to deter the suicidal risk.
There is no method to predict who is to commit suicide, nevertheless, it is possible to evaluate the individual risk of each patient with regards to a detailed and empathic clinical interview. Prevent the patient to commit suicide is the preliminary and fundamental rule.
指导医疗专业人员识别风险因素和保护形式，以及在急诊服务背景下的临床问诊过程中对这类患者的处理。
进行文献综述以识别相关且具有说明性的关键案例。
临床问诊是评估自杀风险的最佳方法，有两个不同目的：1）情感支持和建立联系；2）收集信息。临床问诊过程中有大量信息需要收集，例如：风险因素和保护因素、流行病学数据、行为特征、心理动力学方面、个人和家族病史模式、识别模型、身体状况和社会网络支持数据。临床问诊过程中会出现困难，但训练有素且见多识广的专业人员将能够接近并充分应对患者。尽管已经提出了几种量表，但没有一种能有效阻止自杀风险。
没有方法可以预测谁会自杀，然而，通过详细且共情的临床问诊来评估每个患者的个体风险是可能的。防止患者自杀是首要和根本原则。
