LVR-Klinik, Abteilung Abhängigkeitserkrankungen, Wilhelm-Griesinger-Str 23, 51109 Cologne, Germany.
Eur Arch Psychiatry Clin Neurosci. 2012 Nov;262 Suppl 2:S123-8. doi: 10.1007/s00406-012-0351-6. Epub 2012 Aug 28.
Suicidal behaviour is a serious public health issue. Suicidal behaviour includes completed suicide, suicide attempts, suicidal intent and/or plans and suicide ideation. Two prominent mechanisms, behavioural deficits, in particular poor problem-solving skills, and a certain cognitive style with overgeneralization, distortion and lack of positive expectations, have been identified in suicidal patients so far. Besides general therapy strategies, including the diagnostic process and a collaborative, confident relationship and strengthening of protective factors, specific behavioural strategies should aim at the modification of the behavioural repertoire and of cognitive strategies. The modification of the behavioural repertoire includes the direct modification of the behaviour, acquiring techniques for stress reduction and learning problem-solving strategies. Applied cognitive techniques comprise such as thought-stopping, examining options and alternatives, fantasizing consequences, externalizing inner voices, and reattribution. Psychotherapy with suicidal patients has a specific feature: It requires high activity of the therapist in terms of motivation and guidance of the patient. Regular assessment of the suicide risk at every session is a must. Nevertheless, the therapist should always be aware that it is impossible to prevent all suicidal acts.
自杀行为是一个严重的公共卫生问题。自杀行为包括自杀完成、自杀未遂、自杀意念和/或计划以及自杀意念。迄今为止，在自杀患者中已经确定了两个突出的机制，即行为缺陷，特别是解决问题的能力差，以及一定的认知风格，表现为过度泛化、扭曲和缺乏积极的期望。除了一般的治疗策略，包括诊断过程和合作、信任的关系以及加强保护因素外，特定的行为策略应该旨在改变行为模式和认知策略。行为模式的改变包括直接改变行为、学习减压技术和解决问题的策略。应用的认知技术包括思维阻断、思考选择和替代方案、想象后果、外化内心声音以及归因再分配。对有自杀倾向的患者进行心理治疗有一个特定的特点：它需要治疗师在激励和引导患者方面表现出高度的积极性。每次治疗都必须定期评估自杀风险。然而，治疗师应该始终意识到，不可能预防所有的自杀行为。
